Provider Demographics
NPI:1730132671
Name:ROBERT P. MARTINI JR, D.C.
Entity Type:Organization
Organization Name:ROBERT P. MARTINI JR, D.C.
Other - Org Name:SKYTOP CHIROPRACTIC LIFE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:P
Authorized Official - Last Name:MARTINI
Authorized Official - Suffix:JR
Authorized Official - Credentials:DO
Authorized Official - Phone:814-238-6300
Mailing Address - Street 1:1243 SKYTOP MOUNTAIN RD
Mailing Address - Street 2:SUITE1
Mailing Address - City:PORT MATILDA
Mailing Address - State:PA
Mailing Address - Zip Code:16870-7719
Mailing Address - Country:US
Mailing Address - Phone:814-238-6300
Mailing Address - Fax:814-238-0976
Practice Address - Street 1:1243 SKYTOP MOUNTAIN RD
Practice Address - Street 2:SUITE1
Practice Address - City:PORT MATILDA
Practice Address - State:PA
Practice Address - Zip Code:16870-7719
Practice Address - Country:US
Practice Address - Phone:814-238-6300
Practice Address - Fax:814-238-0976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005430L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006177350001Medicaid
PAPOO268769OtherGROUP RAILROAD MEDICARE
PA0014255700001Medicaid
PAU00507Medicare UPIN
PA0014255700001Medicaid
PA0006177350001Medicaid