Provider Demographics
NPI:1578762100
Name:CLAUDIA T MARTORELL MD LLC
Entity Type:Organization
Organization Name:CLAUDIA T MARTORELL MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:THERESA
Authorized Official - Last Name:MARTORELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MPH
Authorized Official - Phone:413-747-5566
Mailing Address - Street 1:57 MULBERRY ST.
Mailing Address - Street 2:
Mailing Address - City:SPFLD
Mailing Address - State:MA
Mailing Address - Zip Code:01105
Mailing Address - Country:US
Mailing Address - Phone:413-747-5566
Mailing Address - Fax:413-747-5666
Practice Address - Street 1:57 MULBERRY ST.
Practice Address - Street 2:
Practice Address - City:SPFLD
Practice Address - State:MA
Practice Address - Zip Code:01105
Practice Address - Country:US
Practice Address - Phone:413-747-5566
Practice Address - Fax:413-747-5666
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CLAUDIA T MARTORELL MD LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-13
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
MA216851174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110070818AMedicaid
MA9752790Medicaid
MAI08029Medicare UPIN
MAM21760Medicare PIN