Individual
DR. KENNETH CHARLES SPITALNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
80TH ST & 41ST AVE, ELMHURST, NY 11373-1329
(718) 334-3900
(718) 334-5958
Mailing address
7901 BROADWAY, MANAGED CARE, D1-01, ELMHURST, NY 11373-1329
(718) 334-1921
(718) 334-3432
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
158306
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00246075
—
NY
Enumeration date
10/23/2006
Last updated
07/08/2007
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