Provider Demographics
NPI:1790760007
Name:SPITALEWITZ, SAMUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:
Last Name:SPITALEWITZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1 BROOKDALE PLZ
Mailing Address - Street 2:ROOM 169CHC
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11212-3139
Mailing Address - Country:US
Mailing Address - Phone:718-240-5615
Mailing Address - Fax:718-485-4064
Practice Address - Street 1:1 BROOKDALE PLZ
Practice Address - Street 2:ROOM 169CHC
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212-3139
Practice Address - Country:US
Practice Address - Phone:718-240-5615
Practice Address - Fax:718-485-4064
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2020-04-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY127445207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY45A731OtherMEDICARE PTAN
NY5691218OtherAETNA US HEALTHCARE-PPO
NY0083755OtherGHI
NY127445OtherHIP
NY127445-A41Other1199 NBF
NY27N013OtherNEIGHBORHOOD HEALTH PRO
NY3399807OtherGHI
NY5958371-003OtherCIGNA SENIORS
NY5958371-002OtherCIGNA REGULAR
NY000012801OtherAMERICHOICE
NY00639712Medicaid
NY127445-B41Other1199 NBF
NY10988OtherELDERPLAN
NY14-32336OtherUNITED HEALTHCARE
NY6X6611OtherEMPIRE BC/BS
NY0582172OtherAETNA US HEALTHCARE
NYP2085137OtherOXFORD
NY2348380OtherAETNA US HEALTHCARE-HMO
NYKS486OtherOXFORD