Provider Demographics
NPI:1013939321
Name:SPINGOLA, DARIN M
Entity Type:Individual
Prefix:
First Name:DARIN
Middle Name:M
Last Name:SPINGOLA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:898 BEAVER DR
Mailing Address - Street 2:
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-2512
Mailing Address - Country:US
Mailing Address - Phone:814-371-3980
Mailing Address - Fax:814-371-8317
Practice Address - Street 1:898 BEAVER DR
Practice Address - Street 2:
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-2512
Practice Address - Country:US
Practice Address - Phone:814-371-3980
Practice Address - Fax:814-371-8317
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000674152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0013957850001Medicaid
PA688652Medicare ID - Type UnspecifiedMEDICARE ID NO
PA0013957850001Medicaid