Individual
DR. BRETT MICHAEL SPAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
5500 MERRICK RD, MASSAPEQUA, NY 11758-6231
(516) 795-3033
Mailing address
5500 MERRICK RD, MASSAPEQUA, NY 11758-6231
(516) 795-3033
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
254808
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/19/2008
Last updated
06/08/2012
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