Doctor Name: | MS. EMILY DIMARTINO |
NPI Number: | 1568837615 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | AGPCNP-BC |
License Number: | 6389 |
Business Practice Address: | 55 Grand St New Britain, CT - 060522021 |
Business Phone Number: | 8606559197 |
Business Fax Number: | |
Mailing Address: | 47 High St, PORTLAND |
State: | CT |
Postal Code: | 064801669 |
Phone Number: | 8606559197 |
Fax Number: | |
NPI Enumeration Date: | 12/01/2015 |
NPI Last Update Date: | 12/01/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP2300X |
License Number: | 6389 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |