Provider Demographics
NPI:1730197260
Name:SPECTOR, EDWARD D (MD)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:D
Last Name:SPECTOR
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:PO BOX 791
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-0791
Mailing Address - Country:US
Mailing Address - Phone:908-237-5420
Mailing Address - Fax:
Practice Address - Street 1:2100 WESTCOTT DRIVE
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822
Practice Address - Country:US
Practice Address - Phone:888-988-3404
Practice Address - Fax:856-616-1919
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA067007207P00000X
NY232362-01207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7556209Medicaid
G72593Medicare UPIN
NJ7556209Medicaid