Provider Demographics
NPI:1669211827
Name:SPIRIDIGLOIZZI, SHELBEY L
Entity type:Individual
Prefix:
First Name:SHELBEY
Middle Name:L
Last Name:SPIRIDIGLOIZZI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 REESE RD
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:NY
Mailing Address - Zip Code:13340-3404
Mailing Address - Country:US
Mailing Address - Phone:315-867-3144
Mailing Address - Fax:
Practice Address - Street 1:605 PALMER ST
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:NY
Practice Address - Zip Code:13340-1428
Practice Address - Country:US
Practice Address - Phone:315-867-4133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY320350164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse