Provider Demographics
NPI:1679568141
Name:SPAGNUOLO, EUGENE (MD)
Entity type:Individual
Prefix:
First Name:EUGENE
Middle Name:
Last Name:SPAGNUOLO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 E MAIN ST
Mailing Address - Street 2:NORTHERN WESTCHESTER HOSPITAL EMERGENCY DEPARTMENT
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3417
Mailing Address - Country:US
Mailing Address - Phone:914-666-1254
Mailing Address - Fax:914-666-1931
Practice Address - Street 1:400 E MAIN ST
Practice Address - Street 2:NORTHERN WESTCHESTER HOSPITAL, MEDICAL AFFAIRS OFFICE
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-3417
Practice Address - Country:US
Practice Address - Phone:914-242-8318
Practice Address - Fax:914-666-1965
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY214071207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0000085141OtherGHI HMO PIN #
1059586OtherCDPHP
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4798735OtherGHI PPO
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5C7517OtherHEALTHNET
4147744OtherMVP HEALTHPLAN PIN #
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0645R1OtherEMPIRE BC BS
2233284OtherUNITED HEALTHCARE PIN#
1059586OtherCDPHP
5804682OtherAETNA PPO PIN#
P2791668OtherOXFORD HEALTH PLAN PIN#