Provider Demographics
NPI:1578327920
Name:KATHRYN H MARTINEZ PMH-NP MBA LLC
Entity Type:Organization
Organization Name:KATHRYN H MARTINEZ PMH-NP MBA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:H
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC MBA
Authorized Official - Phone:908-339-2147
Mailing Address - Street 1:127 UNION AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:MIDDLESEX
Mailing Address - State:NJ
Mailing Address - Zip Code:08846-1039
Mailing Address - Country:US
Mailing Address - Phone:908-339-2147
Mailing Address - Fax:
Practice Address - Street 1:127 UNION AVE STE 4
Practice Address - Street 2:
Practice Address - City:MIDDLESEX
Practice Address - State:NJ
Practice Address - Zip Code:08846-1039
Practice Address - Country:US
Practice Address - Phone:908-339-2147
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty