Healthcare Provider Details

I. General information

NPI: 1679568141
Provider Name (Legal Business Name): EUGENE SPAGNUOLO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2005
Last Update Date: 05/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E MAIN ST NORTHERN WESTCHESTER HOSPITAL, MEDICAL AFFAIRS OFFICE
MOUNT KISCO NY
10549-3417
US

IV. Provider business mailing address

400 E MAIN ST NORTHERN WESTCHESTER HOSPITAL EMERGENCY DEPARTMENT
MOUNT KISCO NY
10549-3417
US

V. Phone/Fax

Practice location:
  • Phone: 914-242-8318
  • Fax: 914-666-1965
Mailing address:
  • Phone: 914-666-1254
  • Fax: 914-666-1931

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number214071
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: