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General NPI Number Information
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NPI Number | 1689052318
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Entity Type | Individual
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Provider Name | MARIE EMMANUELLE MARTELLY RN
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Gender | Female
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Dates
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Enumeration Date | 05/14/2015
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Last Update Date | 01/23/2023
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Provider Practice Location Address
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Address Line | 5809 MORRIS ST APT B
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City | PHILADELPHIA
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State | PA
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Zip | 19144-3854
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Country | US
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Telephone | 125-327-3485
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Fax |
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Provider Business Mailing Address
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Address Line | 241B BERGEN ST
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City | NEWARK
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State | NJ
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Zip | 07103-2422
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Country | US
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Telephone | 253-273-4853
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 26NJ01397200
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 699755-1
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 26NJ01397200
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License Number State | NJ
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