Basic Information
| Provider Information | |||||||||
| NPI: | 1346229630 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SPYCHALSKI | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | P | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 143 LONGWATER DR | ||||||||
| Address2: | |||||||||
| City: | NORWELL | ||||||||
| State: | MA | ||||||||
| PostalCode: | 020611683 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7818785200 | ||||||||
| FaxNumber: | 7818786750 | ||||||||
| Practice Location | |||||||||
| Address1: | 7 CINEMAGIC WAY | ||||||||
| Address2: | |||||||||
| City: | HOOKSETT | ||||||||
| State: | NH | ||||||||
| PostalCode: | 03106 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6037825112 | ||||||||
| FaxNumber: | 6039322983 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/13/2006 | ||||||||
| LastUpdateDate: | 11/21/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 208532 | MA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 19480 | NH | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 042297845 | 01 | UNITED HEALTH CARE | OTHER | 04297845 | 01 | MULTI-PLAN/PHCS | OTHER | J23562 | 01 | MA | BCBSMA | OTHER | 208532 | 01 | TUFTS & TUFTS MEDICARE PREFERRED | OTHER | 042297845 | 01 | HCVM/FIRST HEALTH/COVENTRY | OTHER | 042297845 | 01 | TRICARE | OTHER | 4396942 | 01 | AETNA | OTHER | AA242359 | 01 | HARVARD PILGRIM | OTHER | 042297845 | 01 | GIC/UNICARE | OTHER | 4881653 | 01 | CIGNA | OTHER |