Individual
SPENCER T MOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1248 AVENUE U, BROOKLYN, NY 11229-4102
(718) 336-1213
Mailing address
1248 AVENUE U, BROOKLYN, NY 11229-4102
(718) 336-1213
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
UVT4921
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01271145
—
NY
01
—
25533B
GHI - MEDICARE
NY
Enumeration date
09/27/2005
Last updated
09/10/2007
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