Provider Demographics
NPI:1487713749
Name:MARTINELLI, CAROL LEE (MPT,WCS)
Entity type:Individual
Prefix:MS
First Name:CAROL
Middle Name:LEE
Last Name:MARTINELLI
Suffix:
Gender:F
Credentials:MPT,WCS
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:LEE
Other - Last Name:HNATUK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:517 WAKE FOREST DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-1197
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:107 CHESAPEAKE BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-6390
Practice Address - Country:US
Practice Address - Phone:410-392-9400
Practice Address - Fax:410-392-0577
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2009-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18115225100000X
DEJ1-1242225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist