MEDICARE: MRS. AMIE MARTINELLI OTR/L

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	225X00000X	Occupational Therapist	46TR00027500	NJ
2	225X00000X	Occupational Therapist	OC002618L	PA

General Provider Information

NPI Number	:	1568695906
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMIE MARTINELLI OTR/L

Provider Business Mailing Address
First Line	:	221 S WASHINGTON AVE
Second Line	:
City	:	MOORESTOWN
State	:	NJ
Zip	:	08057-3517
Country	:	US
Telephone Number	:	856-727-8810
Fax Number	:

Provider Business Practice Location Address
First Line	:	221 S WASHINGTON AVE
Second Line	:
City	:	MOORESTOWN
State	:	NJ
Zip	:	08057-3517
Country	:	US
Telephone Number	:	856-727-8810
Fax Number	:

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

Provider Enumeration Date	:	09/02/2009
Last Update Date	:	09/02/2009

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