Provider Demographics
NPI:1316506769
Name:MARTINO, EMILY LYNN (MSED)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:LYNN
Last Name:MARTINO
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 MEADOW CT
Mailing Address - Street 2:
Mailing Address - City:MANORVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11949-2915
Mailing Address - Country:US
Mailing Address - Phone:631-553-4913
Mailing Address - Fax:
Practice Address - Street 1:430 SILLS RD
Practice Address - Street 2:
Practice Address - City:YAPHANK
Practice Address - State:NY
Practice Address - Zip Code:11980
Practice Address - Country:US
Practice Address - Phone:631-924-5583
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-10
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist