Provider Demographics
NPI:1578592382
Name:SPENCER, BARBARA (NP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:SPENCER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 W 124TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-4920
Mailing Address - Country:US
Mailing Address - Phone:212-531-1300
Mailing Address - Fax:212-531-0141
Practice Address - Street 1:123 W 124TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-4920
Practice Address - Country:US
Practice Address - Phone:212-531-1300
Practice Address - Fax:212-531-0141
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY330469363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner