Healthcare Provider Details

I. General information

NPI: 1881007177
Provider Name (Legal Business Name): EMILY D'AMATO MARTINEZ NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2014
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 EISENHOWER AVE
BEVERLY MA
01915-3851
US

IV. Provider business mailing address

11 EISENHOWER AVE
BEVERLY MA
01915-3851
US

V. Phone/Fax

Practice location:
  • Phone: 508-843-2802
  • Fax:
Mailing address:
  • Phone: 508-843-2802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2278135
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberRN2278135
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: