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General NPI Number Information
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NPI Number | 1891792529
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Entity Type | Individual
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Provider Name | GEORGE A SPRECACE M.D. J.D.
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Gender | Male
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 02/26/2015
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Provider Practice Location Address
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Address Line | 400 BAYONET ST SUITE LL2
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City | NEW LONDON
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State | CT
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Zip | 06320-2600
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Country | US
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Telephone | 860-443-0769
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Fax | 860-443-1278
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Provider Business Mailing Address
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Address Line | 196 PARKWAY S SUITE 304
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City | WATERFORD
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State | CT
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Zip | 06385-1234
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Country | US
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Telephone | 860-442-7027
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Fax | 860-444-0074
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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 | 207RA0201X
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Taxonomy Name | Allergy & Immunology (Internal Medicine) Physician
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License Number | 011104
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License Number State | CT
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