Provider Demographics
NPI:1720509300
Name:MARTORELL, CHISELL (NP)
Entity Type:Individual
Prefix:MS
First Name:CHISELL
Middle Name:
Last Name:MARTORELL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 E 108TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-3858
Mailing Address - Country:US
Mailing Address - Phone:917-693-8001
Mailing Address - Fax:
Practice Address - Street 1:22 E 108TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-3858
Practice Address - Country:US
Practice Address - Phone:917-693-8001
Practice Address - Fax:917-693-8001
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-04
Last Update Date:2017-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY421289363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Single Specialty