Provider Demographics
NPI:1063029411
Name:ERIC SPRONZ, PSYCHIATRIC NURSE PRACTITIONER P.C.
Entity Type:Organization
Organization Name:ERIC SPRONZ, PSYCHIATRIC NURSE PRACTITIONER P.C.
Other - Org Name:EAST END NEURPSYCH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:SPRONZ
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:631-737-6434
Mailing Address - Street 1:2539 MIDDLE COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:CENTEREACH
Mailing Address - State:NY
Mailing Address - Zip Code:11720-3551
Mailing Address - Country:US
Mailing Address - Phone:631-737-6434
Mailing Address - Fax:631-738-1226
Practice Address - Street 1:2539 MIDDLE COUNTRY RD STE 4
Practice Address - Street 2:
Practice Address - City:CENTEREACH
Practice Address - State:NY
Practice Address - Zip Code:11720-3503
Practice Address - Country:US
Practice Address - Phone:631-737-6434
Practice Address - Fax:631-738-1226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-29
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric PsychiatryGroup - Single Specialty
No2084B0040XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBehavioral Neurology & NeuropsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1922332261OtherNPI