Provider Demographics
NPI:1841833167
Name:MARTOCCI, DESIRAE (HEARING AID PROVIDER)
Entity type:Individual
Prefix:MRS
First Name:DESIRAE
Middle Name:
Last Name:MARTOCCI
Suffix:
Gender:F
Credentials:HEARING AID PROVIDER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 HIGHWAY 34 STE 2
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-2167
Mailing Address - Country:US
Mailing Address - Phone:732-991-3361
Mailing Address - Fax:908-982-4822
Practice Address - Street 1:1130 HIGHWAY 34 STE 2
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:NJ
Practice Address - Zip Code:07747-2167
Practice Address - Country:US
Practice Address - Phone:732-991-3361
Practice Address - Fax:908-982-4822
Is Sole Proprietor?:No
Enumeration Date:2019-10-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MG00150900237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist