Provider Demographics
NPI:1871197376
Name:MARTEL, MARCIA MARY
Entity Type:Individual
Prefix:
First Name:MARCIA
Middle Name:MARY
Last Name:MARTEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-8900
Mailing Address - Country:US
Mailing Address - Phone:413-626-8775
Mailing Address - Fax:
Practice Address - Street 1:165 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-8900
Practice Address - Country:US
Practice Address - Phone:413-256-0421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-24
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA23361183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist