Provider Demographics
NPI:1669415766
Name:MARTINELLI, JOSEPH A (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:A
Last Name:MARTINELLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1701 12TH AVE
Mailing Address - Street 2:SUITE G2
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16601-3100
Mailing Address - Country:US
Mailing Address - Phone:814-943-5901
Mailing Address - Fax:814-943-3429
Practice Address - Street 1:620 HOWARD AVE
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-4804
Practice Address - Country:US
Practice Address - Phone:814-943-5901
Practice Address - Fax:814-943-3429
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD057928L207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001583874Medicaid
PA001583874Medicaid
PAG30360Medicare UPIN