Provider Demographics
NPI:1740357441
Name:MARTELLO, JULIE (RD, LDN)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:MARTELLO
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:286 WINDSOR RDG UNIT 24
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16105-9141
Mailing Address - Country:US
Mailing Address - Phone:724-651-1184
Mailing Address - Fax:
Practice Address - Street 1:26 NESBITT RD STE 151
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16105-3411
Practice Address - Country:US
Practice Address - Phone:724-656-0067
Practice Address - Fax:724-698-1033
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN000864133N00000X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1012236670001Medicaid
PA089412Medicare ID - Type Unspecified