Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YP0228X | Pediatric Otolaryngology | 204961 | NY |
NPI | 1326139379 |
---|---|
Provider Name | William R Spencer |
First Address | Centerport, NY 11721-1603 |
Second Address | Huntington, NY 11743-3409 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2006 |
Last Update Date | 20/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02090068 | (05) | NY |