Provider Demographics
NPI:1093054140
Name:MARTELL, THANIA (MS SPEC EDUC)
Entity Type:Individual
Prefix:MRS
First Name:THANIA
Middle Name:
Last Name:MARTELL
Suffix:
Gender:F
Credentials:MS SPEC EDUC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5730 MOSHOLU AVE
Mailing Address - Street 2:APT. 1-E
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471-2223
Mailing Address - Country:US
Mailing Address - Phone:917-573-4272
Mailing Address - Fax:
Practice Address - Street 1:5730 MOSHOLU AVE
Practice Address - Street 2:APT. 1-E
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10471-2223
Practice Address - Country:US
Practice Address - Phone:917-573-4272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-09
Last Update Date:2013-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist