Provider Demographics
NPI:1790450666
Name:SPINNATO, SAMANTHA R (OD)
Entity Type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:R
Last Name:SPINNATO
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:8614 WESTWOOD CENTER DR FL 9
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2442
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:571-223-6780
Practice Address - Street 1:850 S VALLEY FORGE RD STE 12
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-4261
Practice Address - Country:US
Practice Address - Phone:215-368-4660
Practice Address - Fax:215-368-7176
Is Sole Proprietor?:No
Enumeration Date:2021-08-12
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOEG003843152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist