Provider Demographics
NPI:1760130157
Name:DIMARTINO, ELI RYAN (CERTIFIED DOULA)
Entity Type:Individual
Prefix:
First Name:ELI
Middle Name:RYAN
Last Name:DIMARTINO
Suffix:
Gender:F
Credentials:CERTIFIED DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 SAINT JOHNS RD # 1L
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11385-2339
Mailing Address - Country:US
Mailing Address - Phone:347-440-4299
Mailing Address - Fax:
Practice Address - Street 1:8 SAINT JOHNS RD # 1L
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NY
Practice Address - Zip Code:11385-2339
Practice Address - Country:US
Practice Address - Phone:347-440-4299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-14
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula