Provider Demographics
NPI:1972532059
Name:FRANKLIN H SPIRN MD INC
Entity Type:Organization
Organization Name:FRANKLIN H SPIRN MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MGR.
Authorized Official - Prefix:MR
Authorized Official - First Name:TARAS
Authorized Official - Middle Name:
Authorized Official - Last Name:TYLKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-654-6670
Mailing Address - Street 1:1656 OAK TREE RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-2862
Mailing Address - Country:US
Mailing Address - Phone:732-549-8080
Mailing Address - Fax:732-549-0528
Practice Address - Street 1:1656 OAK TREE RD
Practice Address - Street 2:SUITE 3
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-2862
Practice Address - Country:US
Practice Address - Phone:732-549-8080
Practice Address - Fax:732-549-0528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02850500207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8719608Medicaid
NJ4667540001Medicare NSC
NJ052005Medicare PIN