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General NPI Number Information
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NPI Number | 1396890141
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Entity Type | Organization
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Legal Business Name | JULIANNE DEMARTINO, M.D., LLC
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 935 TRAILWOOD DR SUITE A
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City | BOARDMAN
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State | OH
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Zip | 44512-5062
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Country | US
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Telephone | 330-629-2410
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Fax | 330-629-2420
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Provider Business Mailing Address
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Address Line | 935 TRAILWOOD DR SUITE A
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City | BOARDMAN
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State | OH
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Zip | 44512-5062
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Country | US
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Telephone | 330-629-2410
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Fax | 330-629-2420
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. JULIANNE DEMARTINO
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Credential | M.D.
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Telephone | 330-629-2410
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 35073590
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License Number State | OH
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