Provider Demographics
NPI:1639140437
Name:MARTORELLA, ANDREW J (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:J
Last Name:MARTORELLA
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:215 E 68TH ST
Mailing Address - Street 2:SUITE 8
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-5718
Mailing Address - Country:US
Mailing Address - Phone:212-288-2869
Mailing Address - Fax:646-304-6610
Practice Address - Street 1:215 E 68TH ST
Practice Address - Street 2:SUITE 8
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-5718
Practice Address - Country:US
Practice Address - Phone:212-288-2869
Practice Address - Fax:646-304-6610
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-30
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY224881207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
I40277Medicare UPIN
2X4881Medicare ID - Type Unspecified