Provider Demographics
NPI:1245576636
Name:MARTINEZ, ANEL
Entity Type:Individual
Prefix:
First Name:ANEL
Middle Name:
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 1:950 UNDERHILL AVE
Mailing Address - Street 2:APT 5E
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10473-2750
Mailing Address - Country:US
Mailing Address - Phone:917-881-8141
Mailing Address - Fax:718-991-3240
Practice Address - Street 1:950 UNDERHILL AVE
Practice Address - Street 2:APT 5E
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10473-2750
Practice Address - Country:US
Practice Address - Phone:917-881-8141
Practice Address - Fax:718-991-3240
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-12
Last Update Date:2014-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
NY023682-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist