Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 402765 | NY |
NPI | 1013478379 |
---|---|
Provider Name | Zoe Spyralatos |
First Address | Buffalo, NY 14213-2007 |
Second Address | Buffalo, NY 14213-2007 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2019 |
Last Update Date | 20/12/2019 |