1013371178 NPI number — CHRISTINA EAN SPANGLER LMT, CMTPT

Table of content: REGINA IRENE BAKER (NPI 1134711856)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013371178 NPI number — CHRISTINA EAN SPANGLER LMT, CMTPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SPANGLER
Provider First Name:
CHRISTINA
Provider Middle Name:
EAN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LMT, CMTPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SPANGLER
Provider Other First Name:
EAN
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LMT, CMTPT
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1013371178
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/05/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
47 MOUNT VERNON ST
Provider Second Line Business Mailing Address:
APT 2
Provider Business Mailing Address City Name:
WEST ROXBURY
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02132-2824
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
860-977-2766
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
30 GERMANIA ST
Provider Second Line Business Practice Location Address:
BUILDING L, THIRD FLOOR
Provider Business Practice Location Address City Name:
JAMAICA PLAIN
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02130-2315
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-977-2766
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/05/2016

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225700000X , with the licence number:  9371 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com