Provider Demographics
NPI:1487891149
Name:SPOLJARIC, MARIA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:SPOLJARIC
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 1:18 METROPOLITAN OVAL APT 8H
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-6791
Mailing Address - Country:US
Mailing Address - Phone:718-799-6148
Mailing Address - Fax:347-398-9898
Practice Address - Street 1:18 METROPOLITAN OVAL APT 8H
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-6791
Practice Address - Country:US
Practice Address - Phone:718-799-6148
Practice Address - Fax:347-398-9898
Is Sole Proprietor?:No
Enumeration Date:2009-01-15
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013647174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist