Individual
DR. SIMON DANIEL SPIVACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1300 MORRIS PARK AVE, PULMONARY MEDICINE, BRONX, NY 10461-1900
(718) 430-2591
(718) 430-8563
Mailing address
1300 MORRIS PARK AVE, PULMONARY MEDICINE, BRONX, NY 10461-1900
(718) 430-2591
(718) 430-8563
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
189782-1
NY
207RP1001X
Pulmonary Disease Physician
Primary
189782-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01269763
—
NY
Enumeration date
09/23/2005
Last updated
08/23/2007
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