Individual ProviderTracie Ellen DespiritoRegistered NurseNursing Service ProvidersPractice Address400 Viola Rd, Spring Valley, NY 10977-2048(845) 577-6412(845) 577-6000PECOS EnrollmentBased on the most recent information from CMS, provider Tracie Ellen Despirito does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 11:54 AM.Profile DetailsProvider ID1396175691Provider TypeIndividualFull NameDespirito, Tracie EllenTitleMrs.CredentialRNGenderFemaleSole ProprietorNoEnumeration Date11/22/2013Last Updated11/22/2013Contact InformationPractice LocationPractice Address400 Viola Rd, Spring Valley, NY 10977-2048Phone(845) 577-6412Fax(845) 577-6484Mailing LocationMailing Address105 S Madison Ave, Spring Valley, NY 10977-5474Phone(845) 577-6000Fax(845) 577-6358Provider TaxonomiesCodeDescriptionLicenseCode163W00000XPrimaryDescriptionRegistered NurseNursing Service ProvidersLicense658735New York