Provider Demographics
NPI:1922694371
Name:MARTORELLO, NICOLETTE
Entity Type:Individual
Prefix:MS
First Name:NICOLETTE
Middle Name:
Last Name:MARTORELLO
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 1:15081 S STATE AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLEFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44062-9383
Mailing Address - Country:US
Mailing Address - Phone:440-552-9188
Mailing Address - Fax:
Practice Address - Street 1:15081 S STATE AVE
Practice Address - Street 2:
Practice Address - City:MIDDLEFIELD
Practice Address - State:OH
Practice Address - Zip Code:44062-9383
Practice Address - Country:US
Practice Address - Phone:440-552-9188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-18
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)