Provider Demographics
NPI:1881680239
Name:SPIRITO, NICHOLAS (MD)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:
Last Name:SPIRITO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 BARTLETT ST
Mailing Address - Street 2:SUITE 503
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01852-1334
Mailing Address - Country:US
Mailing Address - Phone:978-458-4300
Mailing Address - Fax:978-458-4311
Practice Address - Street 1:33 BARTLETT ST
Practice Address - Street 2:SUITE 503
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-1334
Practice Address - Country:US
Practice Address - Phone:978-458-4300
Practice Address - Fax:978-458-4311
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA48426174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA35352OtherFALLON COMMUNITY HEALTH
MA0163783Medicaid
MA048426OtherTUFTS HEALTH PLAN
MA807996OtherHARVARD PILGRIM
MA1451498OtherCIGNA
MA048426OtherSECURE HORIZONS
MA983385OtherNETWORK HEALTH
MANI C18121OtherBLUE SHIELD
MA17-00542OtherUNITED HEALTHCARE
MA3513310OtherAETNA
MANI C18121OtherBLUE SHIELD
MA35352OtherFALLON COMMUNITY HEALTH