Provider Demographics
NPI:1689757403
Name:SPEISER, ROY MARTIN (DC)
Entity Type:Individual
Prefix:DR
First Name:ROY
Middle Name:MARTIN
Last Name:SPEISER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CARNEY STREET
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-3604
Mailing Address - Country:US
Mailing Address - Phone:516-671-7211
Mailing Address - Fax:516-674-0256
Practice Address - Street 1:100 CARNEY ST
Practice Address - Street 2:
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-3604
Practice Address - Country:US
Practice Address - Phone:516-671-7211
Practice Address - Fax:516-674-0256
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX12131111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor