Provider Demographics
NPI:1215182043
Name:MARTINEZ, ALBA LUCIA
Entity Type:Individual
Prefix:
First Name:ALBA
Middle Name:LUCIA
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1908 HALF MOON BAY DR
Mailing Address - Street 2:
Mailing Address - City:CROTON ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:10520-3123
Mailing Address - Country:US
Mailing Address - Phone:914-271-4024
Mailing Address - Fax:
Practice Address - Street 1:1908 HALF MOON BAY DR
Practice Address - Street 2:
Practice Address - City:CROTON ON HUDSON
Practice Address - State:NY
Practice Address - Zip Code:10520-3123
Practice Address - Country:US
Practice Address - Phone:914-271-4024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-20
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007070225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist