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Organization

JACQUELINE M SPENCER DO PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JACQUELINE M SPENCER DO (PRESIDENT)
(631) 254-8500
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
214310
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02109855
NY
Enumeration date
10/11/2006
Last updated
07/01/2010
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