Provider Demographics
NPI:1821235805
Name:MARTINEZ, LILIANA CONSUELO (MS,OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:LILIANA
Middle Name:CONSUELO
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:MS,OTR/L
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1818 BUSHWICK AVE
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-2941
Mailing Address - Country:US
Mailing Address - Phone:516-208-9922
Mailing Address - Fax:516-208-9922
Practice Address - Street 1:384 E 149TH ST
Practice Address - Street 2:SUITE 614
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10455-3908
Practice Address - Country:US
Practice Address - Phone:718-585-0614
Practice Address - Fax:718-993-4999
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-13
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY011108225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics