Provider Demographics
NPI:1700848322
Name:CAREY MARTENS, PAULA M (PT)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:M
Last Name:CAREY MARTENS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MRS
Other - First Name:PAULA
Other - Middle Name:M
Other - Last Name:CAREY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:8390 OSWEGO RD
Mailing Address - Street 2:
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13090
Mailing Address - Country:US
Mailing Address - Phone:315-652-4323
Mailing Address - Fax:315-622-1110
Practice Address - Street 1:8390 OSWEGO RD
Practice Address - Street 2:
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13090-1002
Practice Address - Country:US
Practice Address - Phone:315-652-4323
Practice Address - Fax:315-622-1110
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005641225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00763988Medicaid
NYCC1515Medicare PIN
NYR57023Medicare UPIN