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NPI Code Detail

MEDICARE: DR. RONALD SPINELLE DOC

MEDICARE: DR. RONALD SPINELLE DOC
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
1111NR0400XRehabilitation ChiropractorX007048-1NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CO7048OTHERNYWORKER'S COMPENSATION

General Provider Information

NPI Number : 1124184387
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RONALD SPINELLE DOC
Provider Business Mailing Address
First Line : 5 LEE CT
Second Line :
City : LAKE GROVE
State : NY
Zip : 11755-2205
Country : US
Telephone Number : 631-737-2014
Fax Number :
Provider Business Practice Location Address
First Line : 636 MIDDLE COUNTRY RD
Second Line :
City : SELDEN
State : NY
Zip : 11784-2500
Country : US
Telephone Number : 631-736-4414
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/29/2006
Last Update Date : 07/08/2007

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Directions to “ DR. RONALD SPINELLE DOC” Practice Location

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