Provider Demographics
NPI:1194167965
Name:SPARACINO, LAUREN MARIE (MS)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:MARIE
Last Name:SPARACINO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 ELMWOOD PARK DR APT 19
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-7516
Mailing Address - Country:US
Mailing Address - Phone:718-612-0289
Mailing Address - Fax:
Practice Address - Street 1:65 ELMWOOD PARK DR APT 19
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-7516
Practice Address - Country:US
Practice Address - Phone:718-612-0289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-22
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist