Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | OS020241 | PA |
N | 111NI0900X | Internist | OS020241 | PA |
Y | 207RH0002X | Hospice and Palliative Medicine | OS020241 | PA |
NPI | 1063948396 |
---|---|
Provider Name | Spencer J Menapace |
First Address | Hershey, PA 17033-0858 |
Second Address | Hershey, PA 17033-2360 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2017 |
Last Update Date | 21/06/2021 |