Provider Demographics
NPI:1457547721
Name:DONATELLI MARTIN, DONATELLA P (PT)
Entity type:Individual
Prefix:
First Name:DONATELLA
Middle Name:P
Last Name:DONATELLI MARTIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:DONATELLA
Other - Middle Name:P
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1297 S BEELER CT
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80247-2349
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7821 W 38TH AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6109
Practice Address - Country:US
Practice Address - Phone:303-333-3493
Practice Address - Fax:303-420-4649
Is Sole Proprietor?:No
Enumeration Date:2007-09-20
Last Update Date:2022-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCOAAA1695Medicare PIN