MEDICARE: SARA A MARTINELLI PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1265084560
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA A MARTINELLI PA

Provider Business Mailing Address
First Line	:	335 E MAHN CT
Second Line	:
City	:	OAK CREEK
State	:	WI
Zip	:	53154-2155
Country	:	US
Telephone Number	:	414-762-2020
Fax Number	:

Provider Business Practice Location Address
First Line	:	7793 W APPLETON AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53222-2009
Country	:	US
Telephone Number	:	414-393-9810
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/16/2019
Last Update Date	:	12/13/2021

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Directions to “ SARA A MARTINELLI PA” Practice Location

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