Individual
MS. MARY MARTELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
41 MALL RD, LAHEY CLINIC, BURLINGTON, MA 01805-0001
(781) 744-8608
Mailing address
41 MALL RD, LAHEY CLINIC, BURLINGTON, MA 01805-0001
(781) 744-8608
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
128779
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0705934
—
MA
Enumeration date
02/27/2006
Last updated
12/10/2012
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