Provider Demographics
NPI:1205231263
Name:DEMARTINO, EMILY (DNP, APRN)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:DEMARTINO
Suffix:
Gender:F
Credentials:DNP, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 COLLEGE STREET
Mailing Address - Street 2:PATTIE J. GROVES HEALTH CENTER
Mailing Address - City:SOUTH HADLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01075-0538
Mailing Address - Country:US
Mailing Address - Phone:413-538-2242
Mailing Address - Fax:413-538-2352
Practice Address - Street 1:50 COLLEGE STREET
Practice Address - Street 2:PATTIE J. GROVES HEALTH CENTER
Practice Address - City:SOUTH HADLEY
Practice Address - State:MA
Practice Address - Zip Code:01075-0538
Practice Address - Country:US
Practice Address - Phone:413-538-2242
Practice Address - Fax:413-538-2352
Is Sole Proprietor?:No
Enumeration Date:2014-11-01
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP014416363LF0000X
MARN350931363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103073596Medicaid
PA103073596Medicaid