Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 007046 | NY |
NPI | 1427262922 |
---|---|
Provider Name | Dr. Michael W Spanakos |
First Address | Great Neck, NY 11022-0184 |
Second Address | Great Neck, NY 11021-3527 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2007 |
Last Update Date | 08/07/2007 |