Provider Demographics
NPI:1073829545
Name:MARTINEZ, SANITAGO JR (LMSW)
Entity Type:Individual
Prefix:MR
First Name:SANITAGO
Middle Name:
Last Name:MARTINEZ
Suffix:JR
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:348 13TH ST STE 203
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-6179
Mailing Address - Country:US
Mailing Address - Phone:718-788-5101
Mailing Address - Fax:
Practice Address - Street 1:350 BEACH 88TH ST
Practice Address - Street 2:
Practice Address - City:ROCKAWAY BEACH
Practice Address - State:NY
Practice Address - Zip Code:11693-1421
Practice Address - Country:US
Practice Address - Phone:718-536-4379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-23
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY08991091041S0200X
NY80898104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool