Provider Demographics
NPI:1093786642
Name:MARIA SPINAK, MD, PC
Entity type:Organization
Organization Name:MARIA SPINAK, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:SPINAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-735-5666
Mailing Address - Street 1:169 N MIDDLETOWN RD
Mailing Address - Street 2:
Mailing Address - City:PEARL RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:10965-2029
Mailing Address - Country:US
Mailing Address - Phone:845-735-5666
Mailing Address - Fax:845-735-5673
Practice Address - Street 1:169 N MIDDLETOWN RD
Practice Address - Street 2:
Practice Address - City:PEARL RIVER
Practice Address - State:NY
Practice Address - Zip Code:10965-2029
Practice Address - Country:US
Practice Address - Phone:845-735-5666
Practice Address - Fax:845-735-5673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-31
Last Update Date:2009-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY182922089OtherPALMETTO GBA RAILROAD MEDICARE
NYDD5932OtherPALMETTO GBA RAILROAD MEDICARE
NY0900390001Medicare NSC
NY182922089Medicare PIN
NY180017200Medicare PIN
NYDD5932Medicare PIN
NY182922089OtherPALMETTO GBA RAILROAD MEDICARE
NJ092828Medicare PIN