MEDICARE: ALICIA LAUREN SPINELLI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	41YS00648500	NJ

General Provider Information

NPI Number	:	1043500986
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICIA LAUREN SPINELLI

Provider Business Mailing Address
First Line	:	31 UPTON WAY
Second Line	:
City	:	SEWELL
State	:	NJ
Zip	:	08080-3621
Country	:	US
Telephone Number	:	856-981-1242
Fax Number	:

Provider Business Practice Location Address
First Line	:	18 W LAUREL RD
Second Line	:
City	:	STRATFORD
State	:	NJ
Zip	:	08084-1718
Country	:	US
Telephone Number	:	856-784-2400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2011
Last Update Date	:	04/12/2011

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Directions to “ ALICIA LAUREN SPINELLI ” Practice Location

Language	Start Address	Practice Location

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