Provider Demographics
NPI:1043584063
Name:ROSS SPILLER, PATRICIA (RN)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:
Last Name:ROSS SPILLER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 1ST AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-4004
Mailing Address - Country:US
Mailing Address - Phone:212-802-1673
Mailing Address - Fax:
Practice Address - Street 1:400 1ST AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-4004
Practice Address - Country:US
Practice Address - Phone:212-802-1673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-08
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY501504163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse