Provider Demographics
NPI:1659783371
Name:SPERANDEO, JANETTE M (NP)
Entity Type:Individual
Prefix:MS
First Name:JANETTE
Middle Name:M
Last Name:SPERANDEO
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:310 PRAIRIE CT
Mailing Address - Street 2:
Mailing Address - City:MANORVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11949-2655
Mailing Address - Country:US
Mailing Address - Phone:631-509-1354
Mailing Address - Fax:631-509-1354
Practice Address - Street 1:5 ROOSEVELT AVENUE
Practice Address - Street 2:
Practice Address - City:PORT JEFFERSON STATION
Practice Address - State:NY
Practice Address - Zip Code:11776
Practice Address - Country:US
Practice Address - Phone:631-732-6984
Practice Address - Fax:631-732-7019
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-29
Last Update Date:2014-05-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY474893363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health