Jacqueline M Spencer DO PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

214310 Issued in NY

Legal business name

JACQUELINE M SPENCER DO PC

Practice address

1452 Deer Park Ave
North Babylon, NY 11703

Phone

(631) 254-8500

Fax

(631) 254-8503

NPI assigned

Oct 11, 2006

Last updated

Jul 1, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jacqueline M Spencer, DONPI 1306838669

Title

President

Phone

(631) 254-8500

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jacqueline M Spencer, DO

  • Family Medicine Physician
  • North Babylon, NY
  • NPI 1306838669
  Authorized official Same address or phone
• Ryan M. Cahill, D.O.

  • Family Medicine Physician
  • Deer Park, NY
  • NPI 1437250032
  NPD (past)
• Joan Elizabeth Marchant, RD, CDN

  • Registered Dietitian
  • Farmingdale, NY
  • NPI 1508195785
  NPD (past)
• Goldy L Pascal, ARNP

  • Family Nurse Practitioner
  • Shelton, CT
  • NPI 1730386038
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277942400000",
    "number": "1386732774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4567 CROSSROADS PARK DR.",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "13088",
            "telephone_number": "315-295-2100",
            "fax_number": "315-295-2125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1452 DEER PARK AVE",
            "city": "NORTH BABYLON",
            "state": "NY",
            "postal_code": "11703",
            "telephone_number": "631-254-8500",
            "fax_number": "631-254-8503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACQUELINE M SPENCER DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2010-07-01",
        "status": "A",
        "authorized_official_last_name": "SPENCER",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-254-8500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "214310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02109855",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ivan Klayman OD PC
• Shankar P Iyer, MD
• Shan Jaffery, FNP-BC
• James J Goetz
• Elsy Jean-Jacques, LPN
• Sabine Yves-Marie Jean
• Jeffrey M Nakhjavan DO PC

• Family Medicine Physician in North Babylon, NY
• Providers in North Babylon, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.