Provider Demographics
NPI:1457447757
Name:SPINELLI, HENRY M (MD)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:M
Last Name:SPINELLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:875 FIFTH AVENUE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4952
Mailing Address - Country:US
Mailing Address - Phone:212-570-6235
Mailing Address - Fax:212-570-4168
Practice Address - Street 1:875 FIFTH AVENUE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4952
Practice Address - Country:US
Practice Address - Phone:212-570-6235
Practice Address - Fax:212-570-4168
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1511752086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
E91314Medicare UPIN
023201Medicare ID - Type Unspecified