Healthcare Provider Details

I. General information

NPI: 1134189665
Provider Name (Legal Business Name): DAVID B SPECTOR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2006
Last Update Date: 01/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2410 RIDGEWAY AVE
ROCHESTER NY
14626-4114
US

IV. Provider business mailing address

2410 RIDGEWAY AVE
ROCHESTER NY
14626-4114
US

V. Phone/Fax

Practice location:
  • Phone: 585-723-2841
  • Fax: 585-723-6877
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number131833
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: