Provider Demographics
NPI:1588336077
Name:SPARANDERO, SEAN FRANCIS
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:FRANCIS
Last Name:SPARANDERO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 HAWTHORNE RD
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-5119
Mailing Address - Country:US
Mailing Address - Phone:646-675-0492
Mailing Address - Fax:
Practice Address - Street 1:50 HAWTHORNE RD
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-5119
Practice Address - Country:US
Practice Address - Phone:646-675-0492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-02
Last Update Date:2021-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY629903163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice