Provider Demographics
NPI:1649872599
Name:DAVID MARTINEZ, SEBASTIAN ALBERTO (RPH)
Entity type:Individual
Prefix:
First Name:SEBASTIAN
Middle Name:ALBERTO
Last Name:DAVID MARTINEZ
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 EAST ST APT 246D
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-5483
Mailing Address - Country:US
Mailing Address - Phone:603-858-2307
Mailing Address - Fax:
Practice Address - Street 1:630 LAFAYETTE RD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:NH
Practice Address - Zip Code:03842-3359
Practice Address - Country:US
Practice Address - Phone:603-926-3344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-14
Last Update Date:2020-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH239265183500000X
NHEL03306183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist