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Organization

SPENCER F. DUBOV, D.P.M., P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SPENCER F. DUBOV D.P.M. (OWNER/PRESIDENT)
(631) 858-0011
Entity
Organization

Contact information

Practice address
73 HAMLET DR, COMMACK, NY 11725-4439
(631) 858-0011
(631) 858-0011
Mailing address
73 HAMLET DR, COMMACK, NY 11725-4439
(631) 858-0011
(631) 858-0011

Taxonomy

Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
002042
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P10342
BLUE CROSS/BLUE SHIELD
NY
Enumeration date
09/21/2007
Last updated
12/18/2007
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