Provider Demographics
NPI:1013180272
Name:MARTINEZ, REBECCA (RPH)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1313 WASHINGTON ST APT 409
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2169
Mailing Address - Country:US
Mailing Address - Phone:617-331-6281
Mailing Address - Fax:
Practice Address - Street 1:214 MARKET ST
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135
Practice Address - Country:US
Practice Address - Phone:617-787-5040
Practice Address - Fax:617-787-5834
Is Sole Proprietor?:No
Enumeration Date:2008-04-09
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH24335183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist