Provider Demographics
NPI:1588545354
Name:SPADARO, CARA
Entity type:Individual
Prefix:
First Name:CARA
Middle Name:
Last Name:SPADARO
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 1:39 VINCENT LN
Mailing Address - Street 2:
Mailing Address - City:STONE RIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:12484-5539
Mailing Address - Country:US
Mailing Address - Phone:843-503-3547
Mailing Address - Fax:
Practice Address - Street 1:12 GAGNON DRIVE
Practice Address - Street 2:
Practice Address - City:STONE RIDGE
Practice Address - State:NY
Practice Address - Zip Code:12484
Practice Address - Country:US
Practice Address - Phone:845-397-7101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-09
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY352408164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse