Provider Demographics
NPI:1295252591
Name:MARTINEZ, JULIANA (PHD)
Entity type:Individual
Prefix:
First Name:JULIANA
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:279 7TH ST APT 1
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-1992
Mailing Address - Country:US
Mailing Address - Phone:787-461-7396
Mailing Address - Fax:
Practice Address - Street 1:2920 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-7164
Practice Address - Country:US
Practice Address - Phone:787-461-7396
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-28
Last Update Date:2017-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist