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NPI Code Detail

MEDICARE: MISS JANINE DEMARTINI

MEDICARE: MISS JANINE DEMARTINI
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
1101Y00000XCounselorNY

General Provider Information

NPI Number : 1477076834
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS JANINE DEMARTINI
Provider Business Mailing Address
First Line : 17A LOVELL AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10314-4943
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1765 SOUTH AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10314-3604
Country : US
Telephone Number : 718-761-9800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2017
Last Update Date : 07/18/2017

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Directions to “ MISS JANINE DEMARTINI ” Practice Location

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