Healthcare Provider Details

I. General information

NPI: 1205762689
Provider Name (Legal Business Name): REBECCA MARIE MARTUCCI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1198 LAKEWOOD RD STE 102
TOMS RIVER NJ
08753-2243
US

IV. Provider business mailing address

534 BALDWIN ST
FORKED RIVER NJ
08731-2340
US

V. Phone/Fax

Practice location:
  • Phone: 732-605-6364
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: