Provider Demographics
NPI:1437741949
Name:MARTINEZ PENA, ARLETY
Entity Type:Individual
Prefix:
First Name:ARLETY
Middle Name:
Last Name:MARTINEZ PENA
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 1:2601 W CLAREMONT ST APT 2079
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85017-6208
Mailing Address - Country:US
Mailing Address - Phone:623-999-4220
Mailing Address - Fax:
Practice Address - Street 1:2601 W CLAREMONT ST APT 2079
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85017-6208
Practice Address - Country:US
Practice Address - Phone:623-999-4220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-05
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy