Provider Demographics
NPI:1679373732
Name:SPROVIERI, VALERIE ROSE (PA-C)
Entity type:Individual
Prefix:MS
First Name:VALERIE
Middle Name:ROSE
Last Name:SPROVIERI
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6301 RIVERDALE AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471-1046
Mailing Address - Country:US
Mailing Address - Phone:718-405-3200
Mailing Address - Fax:
Practice Address - Street 1:6301 RIVERDALE AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10471-1046
Practice Address - Country:US
Practice Address - Phone:718-405-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1232039363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant