Provider Demographics
NPI:1245981711
Name:SPINELLI, SUSANA BEATRIZ
Entity type:Individual
Prefix:
First Name:SUSANA
Middle Name:BEATRIZ
Last Name:SPINELLI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2057 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:NY
Mailing Address - Zip Code:11783-2253
Mailing Address - Country:US
Mailing Address - Phone:718-844-4868
Mailing Address - Fax:
Practice Address - Street 1:2057 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:NY
Practice Address - Zip Code:11783-2253
Practice Address - Country:US
Practice Address - Phone:718-844-4868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-15
Last Update Date:2022-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist