Provider Demographics
NPI:1225329915
Name:SPADARO, DAVID (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:SPADARO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 NEW HAVEN AVE STE 6
Mailing Address - Street 2:
Mailing Address - City:DERBY
Mailing Address - State:CT
Mailing Address - Zip Code:06418-2197
Mailing Address - Country:US
Mailing Address - Phone:203-736-6356
Mailing Address - Fax:203-308-2048
Practice Address - Street 1:111 NEW HAVEN AVE STE 6
Practice Address - Street 2:
Practice Address - City:DERBY
Practice Address - State:CT
Practice Address - Zip Code:06418-2197
Practice Address - Country:US
Practice Address - Phone:203-736-6356
Practice Address - Fax:203-308-2048
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-28
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001872111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor