Provider Demographics
NPI:1659584332
Name:DR. DONALD SPECTOR
Entity Type:Organization
Organization Name:DR. DONALD SPECTOR
Other - Org Name:CAMBRIDGE PODIATRY CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:SPECTOR
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:718-548-3080
Mailing Address - Street 1:259 W 231ST ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-3903
Mailing Address - Country:US
Mailing Address - Phone:718-548-3080
Mailing Address - Fax:718-548-3157
Practice Address - Street 1:259 W 231ST ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-3903
Practice Address - Country:US
Practice Address - Phone:718-548-3080
Practice Address - Fax:718-548-3157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN3990213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00908787Medicaid
NYT51279Medicare UPIN
NY5902930001Medicare NSC
NY00908787Medicaid