Provider Demographics
NPI:1558470716
Name:SPERO, DEBRA A
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:A
Last Name:SPERO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1271 LANDGROVE RD
Mailing Address - Street 2:
Mailing Address - City:LONDONDERRY
Mailing Address - State:VT
Mailing Address - Zip Code:05148-9504
Mailing Address - Country:US
Mailing Address - Phone:802-824-4550
Mailing Address - Fax:
Practice Address - Street 1:215 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WHITE RIVER JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05009-0001
Practice Address - Country:US
Practice Address - Phone:802-295-9363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01517400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist