Provider Demographics
NPI:1295018497
Name:MARTINEZ, WENDY (RD, CDE)
Entity Type:Individual
Prefix:MS
First Name:WENDY
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:RD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:473 RIVERSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07070-2614
Mailing Address - Country:US
Mailing Address - Phone:201-978-0789
Mailing Address - Fax:201-935-3108
Practice Address - Street 1:473 RIVERSIDE AVE
Practice Address - Street 2:
Practice Address - City:RUTHERFORD
Practice Address - State:NJ
Practice Address - Zip Code:07070-2614
Practice Address - Country:US
Practice Address - Phone:201-978-0789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-23
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered