Provider Demographics
NPI:1467864462
Name:MARTINEZ, BELKIS G
Entity Type:Individual
Prefix:
First Name:BELKIS
Middle Name:G
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 1:2840 BAILEY AVE APT D32
Mailing Address - Street 2:BRONX
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-7364
Mailing Address - Country:US
Mailing Address - Phone:646-733-6373
Mailing Address - Fax:
Practice Address - Street 1:2840 BAILEY AVE
Practice Address - Street 2:APT D32
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-7234
Practice Address - Country:US
Practice Address - Phone:646-733-6373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-24
Last Update Date:2014-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY883102252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency