MEDICARE: DR. DONALD SPECTOR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213EP1101X	Primary Podiatric Medicine Podiatrist	N3990	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659584332
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. DONALD SPECTOR

Provider Business Mailing Address
First Line	:	259 W 231ST ST
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10463-3903
Country	:	US
Telephone Number	:	718-548-3080
Fax Number	:	718-548-3157

Provider Business Practice Location Address
First Line	:	259 W 231ST ST
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10463-3903
Country	:	US
Telephone Number	:	718-548-3080
Fax Number	:	718-548-3157

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DONALD SPECTOR
Credential	:	D.P.M.
Telephone Number	:	718-548-3080

Provider Enumeration Date	:	05/08/2007
Last Update Date	:	06/16/2008

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