Provider Demographics
NPI:1851474597
Name:MARTINEZ, CARMEN M (MD)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:M
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:150 55TH ST
Mailing Address - Street 2:STATION 20
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-2559
Mailing Address - Country:US
Mailing Address - Phone:718-630-8758
Mailing Address - Fax:718-210-1059
Practice Address - Street 1:150 55TH ST
Practice Address - Street 2:STATION 20
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-2559
Practice Address - Country:US
Practice Address - Phone:718-630-8758
Practice Address - Fax:718-210-1059
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2012-04-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY148325208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics