Individual
CARLY SPORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4 MAIZE CT, MELVILLE, NY 11747-3224
(516) 987-4292
Mailing address
4 MAIZE CT, MELVILLE, NY 11747-3224
(516) 987-4292
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
04/11/2023
Last updated
04/11/2023
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