Provider Demographics
NPI:1609991843
Name:MANSPEIZER, SHELDON (MD)
Entity Type:Individual
Prefix:DR
First Name:SHELDON
Middle Name:
Last Name:MANSPEIZER
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 1:1 GREENRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-1239
Mailing Address - Country:US
Mailing Address - Phone:914-428-8876
Mailing Address - Fax:914-428-3258
Practice Address - Street 1:1 GREENRIDGE AVE
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-1239
Practice Address - Country:US
Practice Address - Phone:914-428-8876
Practice Address - Fax:914-428-3258
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY090550-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY090550OtherHIP
NYP384719OtherOXFORD
NY194061OtherBCBS
NY090550A14OtherHEALTHFIRST
NY00143393Medicaid
NY0036875OtherGHI
NY0H1586OtherHEALTHNET
NY469137OtherAETNA
NY00143393Medicaid
NY194061OtherBCBS