Individual
JEFFERY SPIRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
263 FARMINGTON AVE, FARMINGTON, CT 06030-0001
(860) 679-2100
(860) 679-4815
Mailing address
263 FARMINGTON AVE, PROVIDER ENROLLMENT, FARMINGTON, CT 06030-2212
(860) 679-7503
(860) 679-1610
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
029071
CT
2086X0206X
Surgical Oncology Physician
029071
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003813403
—
CT
Enumeration date
06/30/2005
Last updated
07/11/2022
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