Provider Demographics
NPI:1316988421
Name:SPATZ, ROBERT J (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:SPATZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:89-06 135TH ST
Mailing Address - Street 2:7L
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11418
Mailing Address - Country:US
Mailing Address - Phone:718-206-6984
Mailing Address - Fax:718-206-6786
Practice Address - Street 1:1 BROOKDALE PLAZA
Practice Address - Street 2:STE 727CHC, TJH MEDICAL SERVICES PC
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212
Practice Address - Country:US
Practice Address - Phone:718-240-5353
Practice Address - Fax:718-240-5367
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY135370207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00573304Medicaid
NY00573304Medicaid
NY32A301Medicare ID - Type Unspecified