Provider Demographics
NPI:1629670567
Name:NIN MARTINEZ, PEDRO (RESPIRATORY THERAPY)
Entity Type:Individual
Prefix:MR
First Name:PEDRO
Middle Name:
Last Name:NIN MARTINEZ
Suffix:
Gender:M
Credentials:RESPIRATORY THERAPY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02456
Mailing Address - Country:US
Mailing Address - Phone:617-438-4167
Mailing Address - Fax:
Practice Address - Street 1:1201 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02465-2122
Practice Address - Country:US
Practice Address - Phone:617-969-4660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA41692279P1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279P1005XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredPulmonary Rehabilitation