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General NPI Number Information
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NPI Number | 1902184195
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Entity Type | Individual
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Provider Name | TERESA MARTORELLA MD
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Gender | Female
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Dates
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Enumeration Date | 07/22/2011
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Last Update Date | 10/14/2016
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Provider Practice Location Address
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Address Line | 2212 GENESEE ST
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City | UTICA
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State | NY
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Zip | 13502-5809
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Country | US
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Telephone | 315-801-3161
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Fax | 315-801-3411
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Provider Business Mailing Address
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Address Line | 2212 GENESEE ST
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City | UTICA
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State | NY
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Zip | 13502-5809
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Country | US
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Telephone | 315-801-3161
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Fax | 315-801-3411
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 273221
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License Number State | NY
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