Provider Demographics
NPI:1518300136
Name:MARTINEZ, CELINA M (LPN)
Entity Type:Individual
Prefix:
First Name:CELINA
Middle Name:M
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:CELINA
Other - Middle Name:M
Other - Last Name:DIAZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:65 CALIFORNIA DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14616-4207
Mailing Address - Country:US
Mailing Address - Phone:585-353-7207
Mailing Address - Fax:
Practice Address - Street 1:65 CALIFORNIA DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14616-4207
Practice Address - Country:US
Practice Address - Phone:585-353-7207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-12
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY237239-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse