Provider Demographics
NPI:1326175548
Name:SPADA, ROSEMARIE J (NP)
Entity type:Individual
Prefix:
First Name:ROSEMARIE
Middle Name:J
Last Name:SPADA
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 102
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-0102
Mailing Address - Country:US
Mailing Address - Phone:781-829-3300
Mailing Address - Fax:
Practice Address - Street 1:520 BOSTON PROVIDENCE HIGHWAY
Practice Address - Street 2:SUITE 8A
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-4962
Practice Address - Country:US
Practice Address - Phone:781-829-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN198689363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAQ77511Medicare UPIN
MANP566602Medicare PIN
MANP566603Medicare PIN
MANP566602Medicare PIN