Healthcare Provider Details
I. General information
NPI: 1750370375
Provider Name (Legal Business Name): ANDREAS M. SPIRIG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/17/2005
Last Update Date: 01/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
21 READE PL SUITE 2200
POUGHKEEPSIE NY
12601-3912
US
IV. Provider business mailing address
1351 ROUTE 55 STE 200
LAGRANGEVILLE NY
12540-5128
US
V. Phone/Fax
- Phone: 845-483-0698
- Fax: 845-483-0699
- Phone: 845-475-9661
- Fax: 845-475-9938
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208G00000X |
| Taxonomy | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
| License Number | 196561-1 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2086S0129X |
| Taxonomy | Vascular Surgery Physician |
| License Number | 196561-1 |
| License Number State | NY |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0204X |
| Taxonomy | Vascular & Interventional Radiology Physician |
| License Number | 196561-1 |
| License Number State | NY |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | 196561-1 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: