Provider Demographics
NPI:1184655359
Name:MARTINKOSKY, STANLEY JOSEPH
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:JOSEPH
Last Name:MARTINKOSKY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3106 MORROW FARM LN
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-9712
Mailing Address - Country:US
Mailing Address - Phone:919-563-6493
Mailing Address - Fax:
Practice Address - Street 1:3106 MORROW FARM LN
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27516-9712
Practice Address - Country:US
Practice Address - Phone:919-563-6493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC492235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC492OtherPROFESSIONAL LICENSE