Provider Demographics
NPI:1881622876
Name:SPITZER, CHRISTINA (MD)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:SPITZER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2287 JOHNSON AVE
Mailing Address - Street 2:APT 17G
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-6400
Mailing Address - Country:US
Mailing Address - Phone:410-294-9456
Mailing Address - Fax:
Practice Address - Street 1:50 SCHOOL ST
Practice Address - Street 2:SUITE 102
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-2534
Practice Address - Country:US
Practice Address - Phone:516-674-0404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-29
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD62768207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDKR79L843Medicare ID - Type Unspecified
MDI34929Medicare UPIN