Provider Demographics
NPI:1215212808
Name:MARTE, AWILDA
Entity Type:Individual
Prefix:
First Name:AWILDA
Middle Name:
Last Name:MARTE
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 1:124 ELLIOT PL
Mailing Address - Street 2:#3E
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10452-7278
Mailing Address - Country:US
Mailing Address - Phone:917-292-6699
Mailing Address - Fax:
Practice Address - Street 1:14-45 143 STREET
Practice Address - Street 2:ROOM 210 WHITESTONE SCHOOL FOR CHILD DEVELOPMENT
Practice Address - City:WHITESTONE
Practice Address - State:NY
Practice Address - Zip Code:11357
Practice Address - Country:US
Practice Address - Phone:718-746-6555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-15
Last Update Date:2011-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant