Spisto, Marc A

Spisto, Marc A is an individual health care provider with primary practice located at 100 Century Dr , Worcester MA 01606-1244. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Spisto, Marc A can be contacted via phone (508) 762-5400.

Contact Information

Primary practice address
100 Century Dr Worcester MA 01606-1244
Phone: (508) 762-5400
Fax: (508) 762-5410
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 7204 Massachusetts

Profile Details

NPI number 1538147822
LBN Legal business name Spisto, Marc A
Credentials ED.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 6th, 2006
Last updated Dec 8th, 2020 - about 4 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 1538147822 NPPES
Massachusetts MEDICAID 110024009A

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