Healthcare Provider Details

I. General information

NPI: 1164617189
Provider Name (Legal Business Name): JAMES M SPINNATO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2007
Last Update Date: 09/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 LYNN ST
PEABODY MA
01960
US

IV. Provider business mailing address

95 LYNN ST
PEABODY MA
01960
US

V. Phone/Fax

Practice location:
  • Phone: 978-538-0115
  • Fax: 978-538-0117
Mailing address:
  • Phone: 978-538-0115
  • Fax: 978-538-0117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number156
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberH489
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: