Provider Demographics
NPI:1467640656
Name:CAMPITELI, MARIETE G
Entity Type:Individual
Prefix:
First Name:MARIETE
Middle Name:G
Last Name:CAMPITELI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 HIGHLAND AVENUE
Mailing Address - Street 2:SON #406
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02143
Mailing Address - Country:US
Mailing Address - Phone:617-591-6768
Mailing Address - Fax:
Practice Address - Street 1:230 HIGHLAND AVE
Practice Address - Street 2:SON #406
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02143-1408
Practice Address - Country:US
Practice Address - Phone:617-591-6768
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-12
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker