Individual
PATRICIA SPECTOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4655 NESCONSET HWY, PORT JEFFERSON STATION, NY 11776-2579
(631) 680-0159
Mailing address
205 ONTARIO ST, RONKONKOMA, NY 11779-4821
(631) 680-0159
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F401611
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407265127
—
NY
Enumeration date
08/06/2014
Last updated
08/06/2014
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