Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | F382774-1 | NY |
NPI | 1043711062 |
---|---|
Provider Name | Ms. Lori Sperber |
First Address | Woodmere, NY 11598-2354 |
Second Address | New York, NY 10003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/02/2018 |
Last Update Date | 10/07/2018 |