Provider Demographics
NPI:1477211878
Name:SPIERTO, MARY H
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:H
Last Name:SPIERTO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 SCENIC VIEW DR
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06778-2219
Mailing Address - Country:US
Mailing Address - Phone:860-484-1941
Mailing Address - Fax:
Practice Address - Street 1:52 SCENIC VIEW DR
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:CT
Practice Address - Zip Code:06778-2219
Practice Address - Country:US
Practice Address - Phone:860-484-1941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-02
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer