Provider Demographics
NPI:1558858084
Name:SOLDANO, SPENSER ALAN (DPM)
Entity Type:Individual
Prefix:DR
First Name:SPENSER
Middle Name:ALAN
Last Name:SOLDANO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 FOOTE AVE
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:14701-7077
Mailing Address - Country:US
Mailing Address - Phone:715-483-2200
Mailing Address - Fax:716-485-7804
Practice Address - Street 1:207 FOOTE AVE
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NY
Practice Address - Zip Code:14701-7077
Practice Address - Country:US
Practice Address - Phone:715-483-2200
Practice Address - Fax:716-485-7804
Is Sole Proprietor?:No
Enumeration Date:2018-04-19
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL390200000X
NYN007248213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program