Healthcare Provider Details

I. General information

NPI: 1326136482
Provider Name (Legal Business Name): WILLIAM S SAPERSTEIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

416 WOLF HILL ROAD
DIX HILLS NY
17746-5742
US

IV. Provider business mailing address

416 WOLF HILL ROAD
DIX HILLS NY
17746-5742
US

V. Phone/Fax

Practice location:
  • Phone: 631-271-7334
  • Fax: 631-423-2552
Mailing address:
  • Phone: 631-271-7334
  • Fax: 631-423-2552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0809371
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: