Healthcare Provider Details

I. General information

NPI: 1275586687
Provider Name (Legal Business Name): ELI INZLICHT-SPREI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 09/04/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 FOSTER AVE STE 200
BROOKLYN NY
11230-1389
US

IV. Provider business mailing address

1010 MCDONALD AVE
BROOKLYN NY
11230-1010
US

V. Phone/Fax

Practice location:
  • Phone: 718-407-7300
  • Fax: 718-859-5717
Mailing address:
  • Phone: 718-407-7300
  • Fax: 718-859-5717

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number159200
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number1592000
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number1592000
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code2081N0008X
TaxonomyNeuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
License Number159200
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: