Provider Demographics
NPI:1689699175
Name:MARTINO, PATRICIA ANNE (NP)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:ANNE
Last Name:MARTINO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:10 DAVOL SQ
Mailing Address - Street 2:SUITE 400
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-4754
Mailing Address - Country:US
Mailing Address - Phone:401-421-4000
Mailing Address - Fax:401-272-1456
Practice Address - Street 1:1351 S COUNTY TRL
Practice Address - Street 2:SUITE 115
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-5079
Practice Address - Country:US
Practice Address - Phone:401-884-0333
Practice Address - Fax:401-884-0096
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RIAPRN01034363LA2200X
RI25772363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q35470Medicare UPIN
21545OtherBC
Q35470Medicare UPIN
410294OtherBCHIP