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General NPI Number Information
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NPI Number | 1225059173
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Entity Type | Organization
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Legal Business Name | LARRY W. SPECTOR, D.O., P.C.
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Dates
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Enumeration Date | 07/23/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7600 CENTRAL AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19111-2442
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Country | US
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Telephone | 610-930-9900
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Fax | 610-930-9905
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Provider Business Mailing Address
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Address Line | PO BOX 3383
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City | MAPLE GLEN
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State | PA
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Zip | 19002-8383
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Country | US
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Telephone | 610-930-9900
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Fax | 610-930-9905
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LARRY SPECTOR
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Credential | D.O.
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Telephone | 610-930-9900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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