Provider Demographics
NPI:1215582259
Name:MARTINEZ, MARIA FRANCES
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:FRANCES
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 1:1879 DOVER RD
Mailing Address - Street 2:
Mailing Address - City:WANTAGH
Mailing Address - State:NY
Mailing Address - Zip Code:11793-3626
Mailing Address - Country:US
Mailing Address - Phone:516-508-1808
Mailing Address - Fax:
Practice Address - Street 1:1879 DOVER RD
Practice Address - Street 2:
Practice Address - City:WANTAGH
Practice Address - State:NY
Practice Address - Zip Code:11793-3626
Practice Address - Country:US
Practice Address - Phone:516-508-1808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-06
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY394614174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist