Provider Demographics
NPI:1346552973
Name:SPOSATO, NANCY (LIC AC)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:
Last Name:SPOSATO
Suffix:
Gender:F
Credentials:LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45B HANCOCK ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-3158
Mailing Address - Country:US
Mailing Address - Phone:617-388-1171
Mailing Address - Fax:
Practice Address - Street 1:45B HANCOCK ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-3158
Practice Address - Country:US
Practice Address - Phone:617-388-1171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-12
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA#466171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist