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General NPI Number Information
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NPI Number | 1972010098
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Entity Type | Individual
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Provider Name | ARMAND MICHAEL MARTINELLI
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Gender | Male
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Dates
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Enumeration Date | 01/10/2018
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Last Update Date | 01/10/2018
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Provider Practice Location Address
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Address Line | 279 N COURTLAND ST
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City | EAST STROUDSBURG
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State | PA
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Zip | 18301-2122
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Country | US
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Telephone | 570-424-8471
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Fax |
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Provider Business Mailing Address
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Address Line | 37 STEMPLE ST
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City | EAST STROUDSBURG
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State | PA
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Zip | 18301-2620
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Country | US
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Telephone | 570-460-9877
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | RT000274A
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License Number State | PA
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