Provider Demographics
NPI:1962522318
Name:SPALIVIERO, MASSIMILIANO (MD)
Entity type:Individual
Prefix:DR
First Name:MASSIMILIANO
Middle Name:
Last Name:SPALIVIERO
Suffix:
Gender:M
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:HSC LEVEL 9 UROLOGY
Mailing Address - Street 2:ROOM 040
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-8093
Mailing Address - Country:US
Mailing Address - Phone:631-444-2348
Mailing Address - Fax:631-444-7620
Practice Address - Street 1:HSC LEVEL 9 UROLOGY
Practice Address - Street 2:ROOM 040
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-8093
Practice Address - Country:US
Practice Address - Phone:631-444-3642
Practice Address - Fax:631-444-6410
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY268507208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology