Provider Demographics
NPI:1063742385
Name:SPOONER, NINA N (MD)
Entity type:Individual
Prefix:DR
First Name:NINA
Middle Name:N
Last Name:SPOONER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:281 GARTH RD
Mailing Address - Street 2:#B6K
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-4052
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:281 GARTH RD
Practice Address - Street 2:#B6K
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-4052
Practice Address - Country:US
Practice Address - Phone:914-472-3693
Practice Address - Fax:914-472-3693
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-08
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY157400208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice