Provider Demographics
NPI:1093179582
Name:SPECTRUM THERAPEUTICS INC
Entity Type:Organization
Organization Name:SPECTRUM THERAPEUTICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:MEYERS
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:718-264-7250
Mailing Address - Street 1:16216 UNION TPKE
Mailing Address - Street 2:SUITE 303
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11366-1958
Mailing Address - Country:US
Mailing Address - Phone:718-264-7250
Mailing Address - Fax:718-264-7922
Practice Address - Street 1:16216 UNION TPKE
Practice Address - Street 2:SUITE 303
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11366-1958
Practice Address - Country:US
Practice Address - Phone:718-264-7250
Practice Address - Fax:718-264-7922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-11
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health