Provider Demographics
NPI:1255693339
Name:SPITZER, JESSICA SUZANN
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:SUZANN
Last Name:SPITZER
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 1:287 MORSEMERE AVE
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10703-2218
Mailing Address - Country:US
Mailing Address - Phone:914-315-1940
Mailing Address - Fax:
Practice Address - Street 1:287 MORSEMERE AVE
Practice Address - Street 2:1ST FLOOR
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10703-2218
Practice Address - Country:US
Practice Address - Phone:914-315-1940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-13
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator