MEDICARE: BEATRICE A SPINELLI M.D.

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	2084P0800X	Psychiatry Physician	40724	MA

General Provider Information

NPI Number	:	1396791190
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BEATRICE A SPINELLI M.D.

Provider Business Mailing Address
First Line	:	100 REMSEN ST
Second Line	:	SUITE 6A
City	:	BROOKLYN
State	:	NY
Zip	:	11201-4256
Country	:	US
Telephone Number	:	718-748-6660
Fax Number	:

Provider Business Practice Location Address
First Line	:	8223 14TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11228-3113
Country	:	US
Telephone Number	:	718-748-6660
Fax Number	:

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

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	07/08/2007

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