Provider Demographics
NPI:1427088285
Name:SPECTOR, NANCY DOLLASE (MD)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:DOLLASE
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 1:635 SUSSEX RD
Mailing Address - Street 2:
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-2204
Mailing Address - Country:US
Mailing Address - Phone:610-645-5636
Mailing Address - Fax:
Practice Address - Street 1:ST. CHRISTOPHER'S HOSPITAL FOR CHILDREN
Practice Address - Street 2:ERIE AVENUE AT FRONT STREET
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134
Practice Address - Country:US
Practice Address - Phone:215-427-8846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD051485L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014943350004Medicaid
PA0014943350004Medicaid
PAF95384Medicare UPIN