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Individual

DR. ANTONIA MORTELLITI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
52 EAST 72 ST, NEW YORK, NY 10021
(212) 439-9775
(212) 439-0796
Mailing address
52 E 72 ST, NEW YORK, NY 10021
(212) 439-9775
(212) 439-0796

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
002077
CT
152W00000X
Optometrist
Primary
TUV0045231
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
561621
AETNA
NY
Enumeration date
02/22/2007
Last updated
07/08/2007
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