Long Island Otolaryngology and Pediatric Airway, PC

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

204961-1 Issued in NY

Legal business name

LONG ISLAND OTOLARYNGOLOGY AND PEDIATRIC AIRWAY, PC

Practice address

25 E Carver St
Huntington, NY 11743-3409

Phone

(631) 470-1579

Fax

(631) 760-2000

NPI assigned

Feb 10, 2009

Organization subpart

No

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

Authorized official

Name

Dr. William Robert Spencer, MDNPI 1326139379

Title

Doctor

Phone

(631) 235-6261

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• William R Spencer, MD

  • Pediatric Otolaryngology Physician
  • Huntington, NY
  • NPI 1326139379
  Medicare reassignment Authorized official
• Kristine Colleluori, RPA-C

  • Physician Assistant
  • Huntington, NY
  • NPI 1285890285
  NPD (past)

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

{
    "created_epoch": "1234224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729036800000",
    "number": "1649419946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 E CARVER ST",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117433409",
            "telephone_number": "631-470-1579",
            "fax_number": "631-760-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 E CARVER ST",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117433409",
            "telephone_number": "631-470-1579",
            "fax_number": "631-760-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG ISLAND OTOLARYNGOLOGY AND PEDIATRIC AIRWAY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-10",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A",
        "authorized_official_last_name": "SPENCER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "631-235-6261",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "NY",
            "license": "204961-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Otolaryngology Physician in Huntington, NY
• Providers in Huntington, NY by specialty
• Otolaryngology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.