Provider Demographics
NPI:1417327974
Name:MARTELLI, DOMINIC FRANCIS
Entity Type:Individual
Prefix:MR
First Name:DOMINIC
Middle Name:FRANCIS
Last Name:MARTELLI
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:DOMINIC
Other - Middle Name:
Other - Last Name:MARTELLI
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:439 CHURCH RD.
Mailing Address - Street 2:APT. 103
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-2621
Mailing Address - Country:US
Mailing Address - Phone:609-540-0100
Mailing Address - Fax:
Practice Address - Street 1:439 CHURCH RD.
Practice Address - Street 2:APT. 103
Practice Address - City:SICKLERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08081-2621
Practice Address - Country:US
Practice Address - Phone:609-540-0100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-28
Last Update Date:2015-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist