Provider Demographics
NPI:1518451608
Name:MARTINEZ, STEPHANIE M
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:M
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 1:16 GRAMERCY GDNS
Mailing Address - Street 2:
Mailing Address - City:MIDDLESEX
Mailing Address - State:NJ
Mailing Address - Zip Code:08846-1686
Mailing Address - Country:US
Mailing Address - Phone:732-439-0233
Mailing Address - Fax:
Practice Address - Street 1:6 CORNWALL CT STE F
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-3347
Practice Address - Country:US
Practice Address - Phone:732-453-4265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-21
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health