Provider Demographics
NPI:1962578757
Name:SPIERER, GARY (MD)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:
Last Name:SPIERER
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 1:78 CROMWELL AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304-3933
Mailing Address - Country:US
Mailing Address - Phone:718-987-9175
Mailing Address - Fax:718-987-1678
Practice Address - Street 1:78 CROMWELL AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10304-3933
Practice Address - Country:US
Practice Address - Phone:718-987-9175
Practice Address - Fax:718-987-1678
Is Sole Proprietor?:No
Enumeration Date:2006-11-26
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY128777207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY230487 LOtherWORKMEN'S COMP
NY230487 LOtherWORKMEN'S COMP
NYB13775Medicare UPIN