Healthcare Provider Details

I. General information

NPI: 1093786642
Provider Name (Legal Business Name): MARIA SPINAK, MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2006
Last Update Date: 11/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

169 N MIDDLETOWN RD
PEARL RIVER NY
10965-2029
US

IV. Provider business mailing address

169 N MIDDLETOWN RD
PEARL RIVER NY
10965-2029
US

V. Phone/Fax

Practice location:
  • Phone: 845-735-5666
  • Fax: 845-735-5673
Mailing address:
  • Phone: 845-735-5666
  • Fax: 845-735-5673

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DR. ANDREW SPINAK
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 845-735-5666