MEDICARE: SPERO E DEMOLEAS

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	213ES0103X	Foot & Ankle Surgery Podiatrist	N0043801	NY

General Provider Information

NPI Number	:	1891972808
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPERO E DEMOLEAS

Provider Business Mailing Address
First Line	:	631 SAW MILL RIVER RD
Second Line	:	STE 1S
City	:	ARDSLEY
State	:	NY
Zip	:	10502-2146
Country	:	US
Telephone Number	:	914-693-8479
Fax Number	:	914-693-8678

Provider Business Practice Location Address
First Line	:	631 SAW MILL RIVER RD
Second Line	:	STE 1S
City	:	ARDSLEY
State	:	NY
Zip	:	10502-2146
Country	:	US
Telephone Number	:	914-693-8479
Fax Number	:	914-693-8678

Authorized Official
Title or Position	:	OWNER
Name	:	SPERO E DEMOLEAS
Credential	:	D.P.M.
Telephone Number	:	914-693-8479

Provider Enumeration Date	:	01/22/2008
Last Update Date	:	01/22/2008

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1235386749 — MS. DIANE M DE LUNA PT
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Directions to “SPERO E DEMOLEAS ” Practice Location

Language	Start Address	Practice Location

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