Provider Demographics
NPI:1215299144
Name:MARK SPITZER, MD P.C.
Entity type:Organization
Organization Name:MARK SPITZER, MD P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:SPITZER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-355-7802
Mailing Address - Street 1:14 MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:NY
Mailing Address - Zip Code:11559-1828
Mailing Address - Country:US
Mailing Address - Phone:516-355-7802
Mailing Address - Fax:516-467-1387
Practice Address - Street 1:1991 MARCUS AVE STE M101
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-2057
Practice Address - Country:US
Practice Address - Phone:516-355-7802
Practice Address - Fax:516-467-1387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-15
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty