Provider Demographics
NPI:1972006427
Name:DR MARTOCCI AND ASSOCIATES, LLC
Entity Type:Organization
Organization Name:DR MARTOCCI AND ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTOCCI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:610-217-2184
Mailing Address - Street 1:2804 WALBERT AVE
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-2400
Mailing Address - Country:US
Mailing Address - Phone:610-439-3937
Mailing Address - Fax:610-439-0215
Practice Address - Street 1:2804 WALBERT AVE
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-2400
Practice Address - Country:US
Practice Address - Phone:610-439-3937
Practice Address - Fax:610-439-0215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-12
Last Update Date:2018-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001107152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty