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Adam David Spivack

Psychiatry & Neurology

Allopathic & Osteopathic Physicians

950 Campbell Ave, West Haven, CT 06516-2770

PECOS Enrollment

This provider is enrolled in PECOS as ADAM SPIVACK.

Based on the most recent information from CMS, provider Adam David Spivack is legally eligible to order and refer claims for DME and PMD services only.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1962439380
Provider Type
Individual
Full Name
Spivack, Adam David
Title
Dr.
Credential
M. D.

Gender
Male
Sole Proprietor
No
Enumeration Date
6/28/2006
Last Updated
9/14/2015

Contact Information

Practice Location

950 Campbell Ave, West Haven, CT 06516-2770

(203) 932-5711

Unlisted Fax

Mailing Location

950 Campbell Ave, West Haven, CT 06516-2770

(203) 932-5711

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 2084P0800X Primary	Description Psychiatry & Neurology Allopathic & Osteopathic Physicians	License 038794 Connecticut

Adam David Spivack

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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