Provider Demographics
NPI:1669525531
Name:SPINI SOL LEVANTE PC
Entity type:Organization
Organization Name:SPINI SOL LEVANTE PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MAURO
Authorized Official - Middle Name:
Authorized Official - Last Name:SPINI
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:201-302-9993
Mailing Address - Street 1:1600 PARKER AVE
Mailing Address - Street 2:STE #1
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-7050
Mailing Address - Country:US
Mailing Address - Phone:201-302-9993
Mailing Address - Fax:201-302-9994
Practice Address - Street 1:1600 PARKER AVE
Practice Address - Street 2:STE #1
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-7050
Practice Address - Country:US
Practice Address - Phone:201-302-9993
Practice Address - Fax:201-302-9994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00633500261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ089312Medicare PIN