Healthcare Provider Details

I. General information

NPI: 1063486785
Provider Name (Legal Business Name): MARTHA B ALBERTI M.S.N., R.N., N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARTHA B DINNEEN M.S.N, R.N., N.P.

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 10/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5516 VIRGINIA BEACH BLVD
VIRGINIA BEACH VA
23462
US

IV. Provider business mailing address

1395 NW 167TH ST
MIAMI GARDENS FL
33169-5710
US

V. Phone/Fax

Practice location:
  • Phone: 757-473-3969
  • Fax: 757-506-0157
Mailing address:
  • Phone: 305-628-6117
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberF301310
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0024175599
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: