Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 116930 | NY |
NPI | 1275766578 |
---|---|
Provider Name | Dr. Susan Spear |
First Address | New York, NY 10024-4960 |
Second Address | New York, NY 10024-4960 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2009 |
Last Update Date | 02/09/2009 |