Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 25MB09887900 | NJ |
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | OS10552 | FL |
N | 207Q00000X | Family Doctor | 25MB09887900 | NJ |
N | 207Q00000X | Family Doctor | OS10552 | FL |
N | 208D00000X | General Practice Physician | 238708 | NY |
NPI | 1053514653 |
---|---|
Provider Name | Dr. Scott Evan Spagnolo-Hye |
First Address | Stratford, NJ 08084-1354 |
Second Address | Stratford, NJ 08084-1354 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2007 |
Last Update Date | 12/07/2016 |