Healthcare Provider Details

I. General information

NPI: 1225967565
Provider Name (Legal Business Name): RICK MARTELLI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 MAIN ST STE 325
BURLINGTON VT
05401-8427
US

IV. Provider business mailing address

30 MAIN ST STE 325
BURLINGTON VT
05401-8427
US

V. Phone/Fax

Practice location:
  • Phone: 802-324-6696
  • Fax:
Mailing address:
  • Phone: 802-324-6696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247000000X
TaxonomyHealth Information Technician
License Number
License Number StateVT
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: