Provider Demographics
NPI:1588652077
Name:SPATZ, ALLISON (MD)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:SPATZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:693 5TH AVE FL 15
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-3160
Mailing Address - Country:US
Mailing Address - Phone:212-540-4210
Mailing Address - Fax:212-540-4213
Practice Address - Street 1:693 5TH AVE FL 15
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-3160
Practice Address - Country:US
Practice Address - Phone:212-540-4210
Practice Address - Fax:212-540-4213
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1987311207R00000X, 207RC0000X
NY198731207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1977809OtherUNITED HEALTHCARE
N87902OtherHEALTH NET
5503052OtherGHI
P2153397OtherOXFORD
1977809OtherUNITED HEALTHCARE
G89976Medicare UPIN