Provider Demographics
NPI:1972085819
Name:MARTOCCI, DONNAMARIE ELIZABETH (FNP - BC)
Entity type:Individual
Prefix:
First Name:DONNAMARIE
Middle Name:ELIZABETH
Last Name:MARTOCCI
Suffix:
Gender:F
Credentials:FNP - BC
Other - Prefix:
Other - First Name:DONNAMARIE
Other - Middle Name:ELIZABETH
Other - Last Name:BLANCHARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6 WELLNESS WAY STE 201
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-2156
Mailing Address - Country:US
Mailing Address - Phone:518-782-3700
Mailing Address - Fax:518-782-3799
Practice Address - Street 1:6 WELLNESS WAY STE 109
Practice Address - Street 2:
Practice Address - City:LATHAM
Practice Address - State:NY
Practice Address - Zip Code:12110-2156
Practice Address - Country:US
Practice Address - Phone:518-785-5881
Practice Address - Fax:518-783-8510
Is Sole Proprietor?:No
Enumeration Date:2018-09-06
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF343524-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily