Provider Demographics
NPI:1922332261
Name:SPRONZ, ERIC RB (RN CASAC NPP)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:RB
Last Name:SPRONZ
Suffix:
Gender:M
Credentials:RN CASAC NPP
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Mailing Address - Street 1:2539 MIDDLE COUNTRY RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:CENTEREACH
Mailing Address - State:NY
Mailing Address - Zip Code:11720-3551
Mailing Address - Country:US
Mailing Address - Phone:631-737-6434
Mailing Address - Fax:
Practice Address - Street 1:2539 MIDDLE COUNTRY RD
Practice Address - Street 2:SUITE 4
Practice Address - City:CENTEREACH
Practice Address - State:NY
Practice Address - Zip Code:11720-3551
Practice Address - Country:US
Practice Address - Phone:631-737-6434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-18
Last Update Date:2020-10-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY402014363LP0808X
NY17808101YA0400X
NY664292163WA0400X
NY298173164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)
No164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03141944Medicaid