Healthcare Provider Details

I. General information

NPI: 1306992359
Provider Name (Legal Business Name): STEVEN B. SPIELMAN, PH.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 10/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 GREENLAND RD SUITE B-4
PORTSMOUTH NH
03801-4164
US

IV. Provider business mailing address

875 GREENLAND RD SUITE B-4
PORTSMOUTH NH
03801-4164
US

V. Phone/Fax

Practice location:
  • Phone: 603-749-0727
  • Fax: 603-749-0727
Mailing address:
  • Phone: 603-749-0727
  • Fax: 603-749-0727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number759
License Number StateNH

VIII. Authorized Official

Name: DR. STEVEN SPIELMAN
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 603-749-0727