Provider Demographics
NPI:1427579986
Name:MARTINI, MARIE CHRISTINA (LMT)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:CHRISTINA
Last Name:MARTINI
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5900 N BURDICK ST STE 201
Mailing Address - Street 2:
Mailing Address - City:EAST SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057-9463
Mailing Address - Country:US
Mailing Address - Phone:315-373-5994
Mailing Address - Fax:315-627-0273
Practice Address - Street 1:5900 N BURDICK ST STE 201
Practice Address - Street 2:
Practice Address - City:EAST SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13057-9463
Practice Address - Country:US
Practice Address - Phone:315-373-5994
Practice Address - Fax:315-627-0273
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029782-1225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty