Provider Demographics
NPI:1235820333
Name:SPICOLA, CLAUDIA ANN
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:ANN
Last Name:SPICOLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8079 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EDEN
Mailing Address - State:NY
Mailing Address - Zip Code:14057-1118
Mailing Address - Country:US
Mailing Address - Phone:716-992-9734
Mailing Address - Fax:716-992-4886
Practice Address - Street 1:8079 N MAIN ST
Practice Address - Street 2:
Practice Address - City:EDEN
Practice Address - State:NY
Practice Address - Zip Code:14057-1118
Practice Address - Country:US
Practice Address - Phone:716-992-9734
Practice Address - Fax:716-992-4886
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-18
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1726031183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183700000XPharmacy Service ProvidersPharmacy TechnicianGroup - Single Specialty