Provider Demographics
NPI:1982387049
Name:MARTI, JESSICA (CD, CPPD)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:MARTI
Suffix:
Gender:F
Credentials:CD, CPPD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 FOLSOM AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-1037
Mailing Address - Country:US
Mailing Address - Phone:347-832-9139
Mailing Address - Fax:
Practice Address - Street 1:89 FOLSOM AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-1037
Practice Address - Country:US
Practice Address - Phone:347-832-9139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ3958-15374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula