Provider Demographics
NPI:1407064223
Name:BAYSIDE MEDICAL PC
Entity Type:Organization
Organization Name:BAYSIDE MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDRE
Authorized Official - Middle Name:
Authorized Official - Last Name:SPINDLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-364-2282
Mailing Address - Street 1:67 EAGLE CHASE
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11797-2915
Mailing Address - Country:US
Mailing Address - Phone:516-364-2282
Mailing Address - Fax:516-364-8928
Practice Address - Street 1:67 EAGLE CHASE
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NY
Practice Address - Zip Code:11797-2915
Practice Address - Country:US
Practice Address - Phone:516-364-2282
Practice Address - Fax:516-364-8928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty