Provider Demographics
NPI:1548437742
Name:SPINELLI, LEAH ANN (RP)
Entity type:Individual
Prefix:
First Name:LEAH ANN
Middle Name:
Last Name:SPINELLI
Suffix:
Gender:F
Credentials:RP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:MIDLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07432-1728
Mailing Address - Country:US
Mailing Address - Phone:201-652-6875
Mailing Address - Fax:
Practice Address - Street 1:10 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:MIDLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:07432-1728
Practice Address - Country:US
Practice Address - Phone:201-652-6875
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-15
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ16282183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist