Provider Demographics
NPI:1467594788
Name:MARTINEZ, MARIA MERCEDES
Entity Type:Individual
Prefix:MS
First Name:MARIA MERCEDES
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 1:42 HICKS ST
Mailing Address - Street 2:#9
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-6905
Mailing Address - Country:US
Mailing Address - Phone:646-265-3049
Mailing Address - Fax:
Practice Address - Street 1:3764 72ND STREET
Practice Address - Street 2:QUEENS COUNTY NEUROPSYCHIATRIC INST
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-6143
Practice Address - Country:US
Practice Address - Phone:718-335-3434
Practice Address - Fax:718-335-4731
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0674961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical