Provider Demographics
NPI:1629202494
Name:SPROTT, PHILMORE M
Entity Type:Individual
Prefix:MR
First Name:PHILMORE
Middle Name:M
Last Name:SPROTT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2384 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11233-3402
Mailing Address - Country:US
Mailing Address - Phone:718-272-6025
Mailing Address - Fax:718-566-2097
Practice Address - Street 1:2384 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11233-3402
Practice Address - Country:US
Practice Address - Phone:718-272-6025
Practice Address - Fax:718-566-2097
Is Sole Proprietor?:No
Enumeration Date:2009-05-08
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker