Healthcare Provider Details

I. General information

NPI: 1154689867
Provider Name (Legal Business Name): ALLISON BROOKE SPITZER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2012
Last Update Date: 07/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 VERMONT DRIVE CENTER FOR PEDIATRIC ORTHOPAEDIC SURGERY
NEW HYDE PARK NY
11042
US

IV. Provider business mailing address

CENTER FOR PEDIATRIC ORTHOPAEDIC SURGERY 7 VERMONT DRIVE
NEW HYDE PARK NY
11042
US

V. Phone/Fax

Practice location:
  • Phone: 516-210-8400
  • Fax:
Mailing address:
  • Phone: 516-210-8400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License NumberFS6854891
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: