Provider Demographics
NPI:1306992359
Name:STEVEN B. SPIELMAN, PH.D., P.C.
Entity type:Organization
Organization Name:STEVEN B. SPIELMAN, PH.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SPIELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:603-749-0727
Mailing Address - Street 1:875 GREENLAND RD
Mailing Address - Street 2:SUITE B-4
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-4164
Mailing Address - Country:US
Mailing Address - Phone:603-749-0727
Mailing Address - Fax:603-749-0727
Practice Address - Street 1:875 GREENLAND RD
Practice Address - Street 2:SUITE B-4
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-4164
Practice Address - Country:US
Practice Address - Phone:603-749-0727
Practice Address - Fax:603-749-0727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH759103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHST RE3920Medicare ID - Type Unspecified