Individual
MR. CARL R SPIVACK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1120 MORRIS PARK AVE, 4A, BRONX, NY 10461
(718) 515-8250
Mailing address
1120 MORRIS PARK AVE, 4A, BRONX, NY 10461
(718) 515-8250
(718) 828-4227
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
130258
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00340267
—
NY
Enumeration date
02/23/2006
Last updated
03/07/2023
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