Provider Demographics
NPI:1083820260
Name:SCOTT M SPECTOR MD
Entity Type:Organization
Organization Name:SCOTT M SPECTOR MD
Other - Org Name:DR SCOTT SPECTORS EYECARE CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:LECKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-853-9900
Mailing Address - Street 1:488 MAIN AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-1008
Mailing Address - Country:US
Mailing Address - Phone:203-853-9000
Mailing Address - Fax:203-853-1359
Practice Address - Street 1:488 MAIN AVE STE 2
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-1008
Practice Address - Country:US
Practice Address - Phone:203-853-9900
Practice Address - Fax:203-853-1359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
A9383OtherRAILROAD MEDICARE
CA9383OtherRAILROAD MEDICARE
CT004209799Medicaid
CT004157485Medicaid
CT004209799Medicaid