MEDICARE: DR. ROSEANN J SPATZ AU.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist	000875-1	NY

General Provider Information

NPI Number	:	1326189952
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROSEANN J SPATZ AU.D.

Provider Business Mailing Address
First Line	:	535 WILLOW ST
Second Line	:
City	:	SOUTH HEMPSTEAD
State	:	NY
Zip	:	11550-8018
Country	:	US
Telephone Number	:	516-785-5868
Fax Number	:	516-785-5397

Provider Business Practice Location Address
First Line	:	535 WILLOW ST
Second Line	:
City	:	SOUTH HEMPSTEAD
State	:	NY
Zip	:	11550-8018
Country	:	US
Telephone Number	:	516-785-5868
Fax Number	:	516-785-5397

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/08/2007
Last Update Date	:	03/09/2021

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