# JACQUELINE M SPENCER DO PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386732774
- **Authorized official:** DR. JACQUELINE M SPENCER DO (PRESIDENT)
- **Authorized official phone:** (631) 254-8500

## Contact information

- **Practice address:** 1452 DEER PARK AVE, NORTH BABYLON, NY 11703
- **Practice address phone:** (631) 254-8500
- **Practice address fax:** (631) 254-8503
- **Mailing address:** 4567 CROSSROADS PARK DR., LIVERPOOL, NY 13088
- **Mailing address phone:** (315) 295-2100
- **Mailing address fax:** (315) 295-2125

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 214310 | NY | Yes |

## Other

- **Enumeration date:** 10/11/2006
- **Last updated:** 07/01/2010