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NPI Code Detail

MEDICARE: NICOLE MARIE SPARANDERA

MEDICARE: NICOLE MARIE SPARANDERA
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
1183500000XPharmacist066927NY

General Provider Information

NPI Number : 1982219614
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE MARIE SPARANDERA
Provider Business Mailing Address
First Line : 655 ROSSVILLE AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10309-1718
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 655 ROSSVILLE AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10309-1718
Country : US
Telephone Number : 718-967-2955
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/10/2020
Last Update Date : 09/10/2020

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Directions to “ NICOLE MARIE SPARANDERA ” Practice Location

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