Provider Demographics
NPI:1942062203
Name:SPILLANE, JAMES PETER (DPT)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:PETER
Last Name:SPILLANE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 HENLOPEN GDNS
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-1759
Mailing Address - Country:US
Mailing Address - Phone:201-916-1616
Mailing Address - Fax:
Practice Address - Street 1:1 GRENOBLE PL
Practice Address - Street 2:
Practice Address - City:REHOBOTH BEACH
Practice Address - State:DE
Practice Address - Zip Code:19971-2847
Practice Address - Country:US
Practice Address - Phone:302-226-2691
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-23
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ1-0014830225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist