Individual
MICHAEL P. SPELLICY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
3797-1
NY
152W00000X
Optometrist
Primary
I3-0011433
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00600977
—
NY
Enumeration date
09/20/2005
Last updated
01/19/2022
Update your record
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