Provider Demographics
NPI:1316404221
Name:SPINELLI, JOSEPH FREDERICK (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:FREDERICK
Last Name:SPINELLI
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2110 8TH AVENUE
Mailing Address - Street 2:APT 4C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10026-1637
Mailing Address - Country:US
Mailing Address - Phone:917-922-7186
Mailing Address - Fax:
Practice Address - Street 1:2110 8TH AVENUE
Practice Address - Street 2:APT 4C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10026-1637
Practice Address - Country:US
Practice Address - Phone:917-922-7186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-27
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019285103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical