Provider Demographics
NPI:1790767093
Name:SPIELFOGEL, WILLIAM D (DPM)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:D
Last Name:SPIELFOGEL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:369 93RD ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-6901
Mailing Address - Country:US
Mailing Address - Phone:718-680-6276
Mailing Address - Fax:718-680-2296
Practice Address - Street 1:369 93RD ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-6901
Practice Address - Country:US
Practice Address - Phone:718-680-6276
Practice Address - Fax:718-680-2296
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004601213E00000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Not Answered213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01190183Medicaid
004601AOtherHEALTHFIRST
NY0075409OtherGHI
112977OtherAETNA
4C5521OtherHEALTHNET
0781333OtherCIGNA
PH7981OtherEMPIRE BCBS
WS887OtherOXFORD
PH7981OtherEMPIRE SR PLAN
PH7981OtherEMPIRE BCBS
4C5521OtherHEALTHNET