Doctor Name: | DR. JEANETTE MARTUCCI |
NPI Number: | 1316330822 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSY.D |
License Number: | 5151 |
Business Practice Address: | 468 Columbia Ave Cliffside Park, NJ - 070101909 |
Business Phone Number: | 2019540367 |
Business Fax Number: | |
Mailing Address: | 742 Bergen Blvd, RIDGEFIELD |
State: | NJ |
Postal Code: | 076571435 |
Phone Number: | 2019540367 |
Fax Number: | |
NPI Enumeration Date: | 03/08/2015 |
NPI Last Update Date: | 03/08/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 5151 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |