Provider Demographics
NPI:1992770994
Name:SPERLING, EDWARD J (DPM)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:J
Last Name:SPERLING
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9621 BERGAMO ST
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-6168
Mailing Address - Country:US
Mailing Address - Phone:516-647-6686
Mailing Address - Fax:561-469-2823
Practice Address - Street 1:9621 BERGAMO ST
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-6168
Practice Address - Country:US
Practice Address - Phone:516-647-6686
Practice Address - Fax:561-469-2823
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-22
Last Update Date:2015-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004169213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYT51368Medicare UPIN