Provider Demographics
NPI:1427168111
Name:SPOSILI, RUTH (APRN)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:
Last Name:SPOSILI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 NORMAN CIR
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-4234
Mailing Address - Country:US
Mailing Address - Phone:203-783-1192
Mailing Address - Fax:203-876-8466
Practice Address - Street 1:11 NORMAN CIR
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-4234
Practice Address - Country:US
Practice Address - Phone:203-783-1192
Practice Address - Fax:203-876-8466
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002797364SP0808X, 363LP0808X, 364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
Not Answered363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Not Answered364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
P93997Medicare UPIN