Provider Demographics
NPI:1821869348
Name:SPOONER, HELENA MARIE (FNP)
Entity Type:Individual
Prefix:
First Name:HELENA
Middle Name:MARIE
Last Name:SPOONER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:626 ROUTE 145
Mailing Address - Street 2:
Mailing Address - City:CAIRO
Mailing Address - State:NY
Mailing Address - Zip Code:12413-2414
Mailing Address - Country:US
Mailing Address - Phone:518-755-1715
Mailing Address - Fax:
Practice Address - Street 1:130 MAIN ST
Practice Address - Street 2:
Practice Address - City:CAIRO
Practice Address - State:NY
Practice Address - Zip Code:12413-3112
Practice Address - Country:US
Practice Address - Phone:518-622-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY353303207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine