MEDICARE: ASHLEY LAUREN SPITERI

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	363A00000X	Physician Assistant	150171	NY

General Provider Information

NPI Number	:	1528340940
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY LAUREN SPITERI

Provider Business Mailing Address
First Line	:	240 GRAND BLVD
Second Line	:
City	:	MASSAPEQUA PARK
State	:	NY
Zip	:	11762-2140
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	240 GRAND BLVD
Second Line	:
City	:	MASSAPEQUA PARK
State	:	NY
Zip	:	11762-2140
Country	:	US
Telephone Number	:	516-663-3853
Fax Number	:

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

Provider Enumeration Date	:	09/12/2011
Last Update Date	:	06/28/2023

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Directions to “ ASHLEY LAUREN SPITERI ” Practice Location

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