Provider Demographics
NPI:1376761023
Name:MARTINEZ, JULIE (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JULIA..
Other - Middle Name:
Other - Last Name:MARTINEZ-SANTOS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:70 SEAVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:MARBLEHEAD
Mailing Address - State:MA
Mailing Address - Zip Code:01945-1732
Mailing Address - Country:US
Mailing Address - Phone:781-631-1908
Mailing Address - Fax:781-639-1820
Practice Address - Street 1:118 PLEASANT ST
Practice Address - Street 2:SUITE 2
Practice Address - City:MARBLEHEAD
Practice Address - State:MA
Practice Address - Zip Code:01945-2344
Practice Address - Country:US
Practice Address - Phone:781-724-5855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA763752084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ-12749Medicare ID - Type UnspecifiedMEDICARE B