Provider Demographics
NPI:1972783991
Name:MARTINS THERAPEUTIC SERVICES INC
Entity Type:Organization
Organization Name:MARTINS THERAPEUTIC SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINS
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:718-204-5249
Mailing Address - Street 1:2204 CRESCENT ST
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11105-3106
Mailing Address - Country:US
Mailing Address - Phone:718-204-5249
Mailing Address - Fax:718-204-5249
Practice Address - Street 1:2204 CRESCENT ST
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11105-3106
Practice Address - Country:US
Practice Address - Phone:718-204-5249
Practice Address - Fax:718-204-5249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-07
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00616293Medicaid
NY1142600001Medicare NSC