Provider Demographics
NPI:1316137805
Name:MARTONE, PETER D (DC)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:D
Last Name:MARTONE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 TEAL RD
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01880-1223
Mailing Address - Country:US
Mailing Address - Phone:781-224-0202
Mailing Address - Fax:
Practice Address - Street 1:7 KIMBALL LANE
Practice Address - Street 2:SUITE D
Practice Address - City:LYNNFIELD
Practice Address - State:MA
Practice Address - Zip Code:01940
Practice Address - Country:US
Practice Address - Phone:781-224-0202
Practice Address - Fax:781-224-0606
Is Sole Proprietor?:No
Enumeration Date:2007-07-31
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2440111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY45286Medicare PIN