Provider Demographics
NPI:1952302986
Name:SPIRO, MARTHA S (FNP)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:S
Last Name:SPIRO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:260 NEW LUDLOW RD
Mailing Address - Street 2:WESTERN MASS PHYSICIAN ASSOCIATES INC
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01020-4324
Mailing Address - Country:US
Mailing Address - Phone:413-533-3470
Mailing Address - Fax:413-533-6859
Practice Address - Street 1:247 CABOT ST
Practice Address - Street 2:WESTERN MASS PEDIATRICS-CARE CENTER
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-3927
Practice Address - Country:US
Practice Address - Phone:413-532-2900
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA206257363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0325741Medicaid