Individual
BRENDA SPORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
125-06 101ST AVE, RICHMOND HILL, NY 11419
(718) 849-2900
(718) 559-5468
Mailing address
55 WATER STREET, 2ND FLOOR CRED DEPT, NEW YORK, NY 10041-0004
(646) 680-2888
(516) 542-5556
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
584123-1
NY
363LF0000X
Family Nurse Practitioner
Primary
339449
NY
Other
Enumeration date
08/24/2010
Last updated
09/30/2019
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