Healthcare Provider Details

I. General information

NPI: 1164630398
Provider Name (Legal Business Name): MICHAEL ANTHONY SPECCHIO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 W BRIDGE ST
NEW HOPE PA
18938-1303
US

IV. Provider business mailing address

66 W BRIDGE ST
NEW HOPE PA
18938-1303
US

V. Phone/Fax

Practice location:
  • Phone: 215-862-0636
  • Fax:
Mailing address:
  • Phone: 215-862-0636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAK000484L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number001004-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: