Provider Demographics
NPI:1447239959
Name:SPRANCE, HENRY ERNEST (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:ERNEST
Last Name:SPRANCE
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 MONMOUTH RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WEST LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07764-1177
Mailing Address - Country:US
Mailing Address - Phone:732-263-7922
Mailing Address - Fax:732-263-7949
Practice Address - Street 1:241 MONMOUTH RD
Practice Address - Street 2:SUITE 101
Practice Address - City:WEST LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07764-1177
Practice Address - Country:US
Practice Address - Phone:732-263-7922
Practice Address - Fax:732-263-7949
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-12
Last Update Date:2010-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA065475207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7284306Medicaid
NJ7284306Medicaid
NJ953195Medicare ID - Type Unspecified