Organization
SPARK DEMENTIA CARE, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
M. JUSTIN COFFEY MD (PRESIDENT/DIRECTOR)
(734) 545-0922
Entity
Organization
Contact information
Practice address
224 W 35TH ST STE 500, #2031, NEW YORK, NY 10001
(212) 201-9292
Mailing address
224 W 35TH ST STE 500, #2031, NEW YORK, NY 10001
(212) 201-9292
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Enumeration date
02/06/2025
Last updated
02/06/2025
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