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NPI Code Detail

MEDICARE: JILLIAN MARTINO ATR

MEDICARE:   JILLIAN  MARTINO  ATR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1221700000XArt Therapist

General Provider Information

NPI Number : 1730826017
Entity Type Code : Individual
Provider Name (Legal Business Name) : JILLIAN MARTINO ATR
Provider Business Mailing Address
First Line : 7 ALEXANDER DR
Second Line :
City : FARMINGDALE
State : NY
Zip : 11735-3203
Country : US
Telephone Number : 516-468-5980
Fax Number :
Provider Business Practice Location Address
First Line : 4109 SUNRISE HWY
Second Line :
City : BOHEMIA
State : NY
Zip : 11716-4600
Country : US
Telephone Number : 631-503-1539
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2022
Last Update Date : 05/17/2022

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Directions to “ JILLIAN MARTINO ATR” Practice Location

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