Provider Demographics
NPI:1104815497
Name:SPECTOR, RUTH (MD)
Entity type:Individual
Prefix:DR
First Name:RUTH
Middle Name:
Last Name:SPECTOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 FOX HUNT LN
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11020-1229
Mailing Address - Country:US
Mailing Address - Phone:516-829-4020
Mailing Address - Fax:516-829-4020
Practice Address - Street 1:21 FOX HUNT LN
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11020-1229
Practice Address - Country:US
Practice Address - Phone:516-829-4020
Practice Address - Fax:516-829-4020
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY171197207RC0200X
DEC1-0025467207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01139775Medicaid
NYE36689Medicare UPIN
NY98F451Medicare ID - Type Unspecified