Provider Demographics
NPI:1073047205
Name:SPINOSA, MARGARET (MD)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:SPINOSA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 TOWNSHIP BLVD STE 20
Mailing Address - Street 2:
Mailing Address - City:CAMILLUS
Mailing Address - State:NY
Mailing Address - Zip Code:13031-1678
Mailing Address - Country:US
Mailing Address - Phone:315-708-0091
Mailing Address - Fax:
Practice Address - Street 1:260 TOWNSHIP BLVD STE 20
Practice Address - Street 2:
Practice Address - City:CAMILLUS
Practice Address - State:NY
Practice Address - Zip Code:13031-1678
Practice Address - Country:US
Practice Address - Phone:315-708-0190
Practice Address - Fax:315-488-3284
Is Sole Proprietor?:No
Enumeration Date:2017-04-14
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT214233207RG0100X
390200000X
NY322665207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program