Provider Demographics
NPI:1508363854
Name:MARTINEZ, DENA VALINE (LMT)
Entity Type:Individual
Prefix:MRS
First Name:DENA
Middle Name:VALINE
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4276 MAPLE RD STE 3
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-1040
Mailing Address - Country:US
Mailing Address - Phone:716-831-0011
Mailing Address - Fax:716-831-0012
Practice Address - Street 1:4276 MAPLE RD STE 3
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-1040
Practice Address - Country:US
Practice Address - Phone:716-831-0011
Practice Address - Fax:716-831-0012
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-11
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY225700000XOtherMASSAGE THERAPIST