MEDICARE: STEPHANIE SPENCE

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	174400000X	Specialist	1992462261	NY

General Provider Information

NPI Number	:	1639000219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE SPENCE

Provider Business Mailing Address
First Line	:	29 COOPER ST
Second Line	:
City	:	BABYLON
State	:	NY
Zip	:	11702-2937
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	29 COOPER ST
Second Line	:
City	:	BABYLON
State	:	NY
Zip	:	11702-2937
Country	:	US
Telephone Number	:	516-701-5706
Fax Number	:

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

Provider Enumeration Date	:	05/25/2026
Last Update Date	:	05/25/2026

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Directions to “ STEPHANIE SPENCE ” Practice Location

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