Provider Demographics
NPI:1457811234
Name:MARTINEZ, BIANCA (MD)
Entity type:Individual
Prefix:
First Name:BIANCA
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 PARKER AVE
Mailing Address - Street 2:
Mailing Address - City:MANASQUAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08736-2804
Mailing Address - Country:US
Mailing Address - Phone:732-974-8100
Mailing Address - Fax:
Practice Address - Street 1:240 PARKER AVE
Practice Address - Street 2:
Practice Address - City:MANASQUAN
Practice Address - State:NJ
Practice Address - Zip Code:08736-2804
Practice Address - Country:US
Practice Address - Phone:732-974-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-20
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD477268208100000X
NJ25MA11814200208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation