Most Relevant Information
Provider Data
| NPI Number: | 1003456559 |
| Provider Name: | BARI NICOLE SPORN |
| Entity Type: | Individual |
| Taxonomy Code: | 174400000X |
| Specialty: | Specialist |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/13/2020 |
| Last Updated: | 01/13/2020 |
Provider Practice Location
47 HUMPHREY DR
SYOSSET
NY
117914022
Practice Location Phone/Fax
| Phone: | 5169217171 |
| Fax: |
Provider Mailing Location
47 HUMPHREY DR
SYOSSET
NY
117914022
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |