Spack, Paul Edward

Spack, Paul Edward is an individual health care provider with primary practice located at 102 Durham Rd , Dover NH 03820. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is his primary health care specialty. Spack, Paul Edward can be contacted via phone (603) 742-3222.

Contact Information

Primary practice address
102 Durham Rd Dover NH 03820
Phone: (603) 742-3222
Fax: (603) 742-1799
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 0022 New Hampshire
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 49 New Hampshire

Profile Details

NPI number 1730246224
LBN Legal business name Spack, Paul Edward
Credentials MASTERS DEGREE
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 3rd, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730246224 NPPES
New Hampshire MEDICAID 30421295

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