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General NPI Number Information
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NPI Number | 1891324323
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Entity Type | Individual
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Provider Name | COREY SPECTOR D.O.
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Gender | Male
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Dates
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Enumeration Date | 04/06/2020
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 111 E 210TH ST
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City | BRONX
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State | NY
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Zip | 10467-2401
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Country | US
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Telephone | 718-920-2751
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Fax |
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Provider Business Mailing Address
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Address Line | 211 THOMPSON ST APT 6J
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City | NEW YORK
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State | NY
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Zip | 10012-1368
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Country | US
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Telephone | 330-607-3956
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | DO210012370
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 336566
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License Number State | NY
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