Provider Demographics
NPI:1659643138
Name:MARTINSON, BARBARA MARIE
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:MARIE
Last Name:MARTINSON
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 1:2268 BIRCH ST
Mailing Address - Street 2:
Mailing Address - City:N MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-2801
Mailing Address - Country:US
Mailing Address - Phone:516-623-0040
Mailing Address - Fax:
Practice Address - Street 1:2268 BIRCH ST
Practice Address - Street 2:
Practice Address - City:N MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-2801
Practice Address - Country:US
Practice Address - Phone:516-623-0040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-31
Last Update Date:2012-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY409496163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse