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General NPI Number Information
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NPI Number | 1063029411
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Entity Type | Organization
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Legal Business Name | ERIC SPRONZ, PSYCHIATRIC NURSE PRACTITIONER P.C.
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Dates
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Enumeration Date | 09/29/2020
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Last Update Date | 10/19/2020
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Provider Practice Location Address
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Address Line | 2539 MIDDLE COUNTRY RD STE 4
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City | CENTEREACH
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State | NY
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Zip | 11720-3503
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Country | US
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Telephone | 631-737-6434
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Fax | 631-738-1226
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Provider Business Mailing Address
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Address Line | 2539 MIDDLE COUNTRY RD
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City | CENTEREACH
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State | NY
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Zip | 11720-3551
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Country | US
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Telephone | 631-737-6434
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Fax | 631-738-1226
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Authorized Official
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Title or Position | OWNER
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Name | ERIC SPRONZ
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Credential | N.P
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Telephone | 631-737-6434
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084B0040X
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Taxonomy Name | Behavioral Neurology & Neuropsychiatry Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number |
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License Number State |
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