Provider Demographics
NPI:1124164777
Name:SPITZER, MAUREEN LYNN (MD)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:LYNN
Last Name:SPITZER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:15 CHESTERFIELD ROAD
Mailing Address - Street 2:SUITE 212
Mailing Address - City:EAST LYME
Mailing Address - State:CT
Mailing Address - Zip Code:06333
Mailing Address - Country:US
Mailing Address - Phone:860-739-5557
Mailing Address - Fax:860-691-1980
Practice Address - Street 1:15 CHESTERFIELD ROAD
Practice Address - Street 2:SUITE 212
Practice Address - City:EAST LYME
Practice Address - State:CT
Practice Address - Zip Code:06333
Practice Address - Country:US
Practice Address - Phone:860-739-5557
Practice Address - Fax:860-691-1980
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT0382542084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
G59634Medicare UPIN