Provider Demographics
NPI:1447595905
Name:MARTIN, ZULENKA (CNA)
Entity Type:Individual
Prefix:
First Name:ZULENKA
Middle Name:
Last Name:MARTIN
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 DINSMORE AVE
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-4748
Mailing Address - Country:US
Mailing Address - Phone:347-515-9985
Mailing Address - Fax:
Practice Address - Street 1:910 DINSMORE AVE
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-4748
Practice Address - Country:US
Practice Address - Phone:347-515-9985
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-10
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY342925820210E376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide