Provider Demographics
NPI:1912959263
Name:SPENCE, STEVEN CHRISTOPHER (RPA-C)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:CHRISTOPHER
Last Name:SPENCE
Suffix:
Gender:M
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3915 AVENUE T
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-5027
Mailing Address - Country:US
Mailing Address - Phone:917-560-7440
Mailing Address - Fax:
Practice Address - Street 1:3915 AVENUE T
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-5027
Practice Address - Country:US
Practice Address - Phone:917-560-7440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008979-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
5F5101Medicare ID - Type Unspecified
P72468Medicare UPIN