Individual
DR. VINCENT SPERANDEO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DNP
Contact information
Practice address
1174 ROUTE 112, PORT JEFFERSON STATION, NY 11776-8033
(631) 320-7503
(631) 880-4411
Mailing address
1174 ROUTE 112, PORT JEFFERSON STATION, NY 11776-8033
(631) 320-7503
(631) 880-4411
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
F33169-1
NY
363L00000X
Nurse Practitioner
Primary
F33169-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02426382
—
NY
01
—
1229G1
BCBS
NY
01
—
P00287733
RAILROAD
—
Enumeration date
02/23/2006
Last updated
02/04/2015
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