Spencer, Jacqueline M
Spencer, Jacqueline M is an sole proprietor health care provider with primary practice located at 1452 Deer Park Ave , North Babylon NY 11703. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Spencer, Jacqueline M can be contacted via phone (631) 254-8500.Contact Information
Primary practice address
1452 Deer Park Ave
North Babylon NY 11703
Phone: (631) 254-8500
Fax: (631) 254-8503
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 214310 | New York |
Profile Details
| NPI number | 1306838669 |
|---|---|
| LBN Legal business name | Spencer, Jacqueline M |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 22nd, 2005 |
| Last updated | Mar 9th, 2009 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306838669 | NPPES |
| New York | MEDICAID | 02109855 |
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