Provider Demographics
NPI:1801233150
Name:MARTINEZ, DEBORAH LEE (LPN)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:LEE
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:DEBORAH
Other - Middle Name:LEE
Other - Last Name:FRIEDRICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:700 VETERANS HWY
Mailing Address - Street 2:200
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-2952
Mailing Address - Country:US
Mailing Address - Phone:631-863-3700
Mailing Address - Fax:631-863-3705
Practice Address - Street 1:700 VETERANS HWY
Practice Address - Street 2:200
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-2952
Practice Address - Country:US
Practice Address - Phone:631-863-3700
Practice Address - Fax:631-863-3705
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-28
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY280593251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health