Healthcare Provider Details

I. General information

NPI: 1700463940
Provider Name (Legal Business Name): WILLIAM JOSEPH SPATARO M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2021
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1925 PACIFIC AVE
ATLANTIC CITY NJ
08401-6713
US

IV. Provider business mailing address

1925 PACIFIC AVE
ATLANTIC CITY NJ
08401-6713
US

V. Phone/Fax

Practice location:
  • Phone: 609-441-8063
  • Fax: 609-484-7009
Mailing address:
  • Phone: 609-441-8063
  • Fax: 609-484-7009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number25MA12754100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: