Basic Information
Provider Information
NPI: 1184196297
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SPINOSI
FirstName: MARIA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: PT DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 26 HOSPITALITY WAY
Address2:  
City: ENGLISHTOWN
State: NJ
PostalCode: 077261646
CountryCode: US
TelephoneNumber: 7329913723
FaxNumber:  
Practice Location
Address1: 901 W MAIN ST
Address2:  
City: FREEHOLD
State: NJ
PostalCode: 077282537
CountryCode: US
TelephoneNumber: 7322942700
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/31/2018
LastUpdateDate: 12/31/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X40QA01792600NJY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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