Provider Demographics
NPI:1366641235
Name:DAVID SPEISER M.D.,P.C.
Entity Type:Organization
Organization Name:DAVID SPEISER M.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SPEISER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-599-3333
Mailing Address - Street 1:227 NASSAU BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11552-2219
Mailing Address - Country:US
Mailing Address - Phone:516-599-3333
Mailing Address - Fax:
Practice Address - Street 1:227 NASSAU BLVD
Practice Address - Street 2:
Practice Address - City:WEST HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11552-2219
Practice Address - Country:US
Practice Address - Phone:516-599-3333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-12
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY201937-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
2693337OtherAETNA
401B51OtherBLUE CROSS BLUE SHEILD
P1008727OtherOXFORD
32832POtherHIP
NY02085656Medicaid
32832POtherHIP
NY02085656Medicaid