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Individual

DR. ROMAN SPIVAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
135 DIVISION ST STE 2, ANSONIA, CT 06401-2135
(203) 308-2705
(203) 734-0137
Mailing address
67 MAPLE AVE, DERBY, CT 06418-1328
(203) 732-1330
(203) 732-1332

Taxonomy

Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
259527
NY
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
52868
CT
207RP1001X
Pulmonary Disease Physician
259527
NY
207RP1001X
Pulmonary Disease Physician
Primary
52868
CT

Other

Enumeration date
06/21/2007
Last updated
10/12/2018
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