De Vita, Martin Joseph

De Vita, Martin Joseph is an individual health care provider with primary practice located at 11050 Mt Belvedere Blvd , Fort Drum NY 13602-2603. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. De Vita, Martin Joseph can be contacted via phone (315) 783-8792.

Contact Information

Primary practice address
11050 Mt Belvedere Blvd Fort Drum NY 13602-2603
Phone: (315) 783-8792
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Behavioral Health & Social Service Providers / Clinical 103TC0700X 0810007818 Virginia

Profile Details

NPI number 1629692991
LBN Legal business name De Vita, Martin Joseph
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 2nd, 2020
Last updated Jul 20th, 2026 - about 3 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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