Doctor Name: | DR. SPERO EVAN DEMOLEAS |
NPI Number: | 1295776755 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.P.M. |
License Number: | N004380 |
Business Practice Address: | 215 Old Tappan Rd Old Tappan, NJ - 076757000 |
Business Phone Number: | 2019309090 |
Business Fax Number: | 2019301823 |
Mailing Address: | 215 Old Tappan Rd, OLD TAPPAN |
State: | NJ |
Postal Code: | 076757000 |
Phone Number: | 2019309090 |
Fax Number: | 2019301823 |
NPI Enumeration Date: | 06/08/2006 |
NPI Last Update Date: | 12/02/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | N004380 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NY |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |