Provider Demographics
NPI:1285952515
Name:SPIZUOCO, AMY LYNN (DO)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:LYNN
Last Name:SPIZUOCO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 W 21ST ST RM 307
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-7373
Mailing Address - Country:US
Mailing Address - Phone:646-397-6377
Mailing Address - Fax:772-783-1002
Practice Address - Street 1:54 W 21ST ST RM 307
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-7373
Practice Address - Country:US
Practice Address - Phone:646-397-6377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-11
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY242374207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology