Individual
MR. CARLTON IVOR SPOONER SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
140 ASCH LOOP, APT. 5B, BRONX, NY 10475-4033
(917) 806-0171
Mailing address
140 ASCH LOOP, APT. 5B, BRONX, NY 10475-4033
(917) 806-0171
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
284008-1
NY
Other
Enumeration date
09/14/2012
Last updated
09/14/2012
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