Provider Demographics
NPI:1033006598
Name:SPEAR, BROOKE EDITH
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:EDITH
Last Name:SPEAR
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 1:191 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13126-3026
Mailing Address - Country:US
Mailing Address - Phone:315-341-4348
Mailing Address - Fax:
Practice Address - Street 1:706 S 4TH ST
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:NY
Practice Address - Zip Code:13069-4905
Practice Address - Country:US
Practice Address - Phone:315-887-5250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program