Provider Demographics
NPI:1578559746
Name:MARTORELLA, LOUIS (MD)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:
Last Name:MARTORELLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 ROUTE 304
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-3041
Mailing Address - Country:US
Mailing Address - Phone:845-634-8400
Mailing Address - Fax:845-634-0979
Practice Address - Street 1:510 ROUTE 304
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-3041
Practice Address - Country:US
Practice Address - Phone:845-634-8400
Practice Address - Fax:845-634-0979
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY106723-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY106723OtherHIP #
NY122671OtherAETNA HMO ID #
NY2707OtherMAYAN PPO ID #
NY0D4711OtherHEALTHNET ID#
NY290953OtherEMPIRE BC/BS STONY PT. #
NY4061624OtherAETNA PPO ID #
NY001565OtherCONNECTICARE #
NY17232OtherNYL CARE #
NY290952OtherEMPIRE BC/BS NEW CITY #
NYRS027OtherOXFORD ID #
NY781493OtherMVP #
NY000000010683OtherGHI HMO ID #
NY0058599OtherGHI PPO ID #
NY1601360OtherCHUBB/HEALTHSOURCE #
NY000000010683OtherGHI HMO ID #
NY290952Medicare PIN