Provider Demographics
NPI:1235599739
Name:MARTINEZ, ANNA M
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:M
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 1:128 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:LYNBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11563-3477
Mailing Address - Country:US
Mailing Address - Phone:516-823-9500
Mailing Address - Fax:516-823-9600
Practice Address - Street 1:2515 STEINWAY ST
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11103-3701
Practice Address - Country:US
Practice Address - Phone:347-832-0035
Practice Address - Fax:877-252-9381
Is Sole Proprietor?:No
Enumeration Date:2016-02-26
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator