Provider Demographics
NPI:1700507100
Name:MARTINEZ, MADELIN N
Entity Type:Individual
Prefix:
First Name:MADELIN
Middle Name:N
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:291 LOWELL ST
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-3422
Mailing Address - Country:US
Mailing Address - Phone:617-678-9059
Mailing Address - Fax:
Practice Address - Street 1:350 MAIN ST STE 31
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-5111
Practice Address - Country:US
Practice Address - Phone:781-397-6583
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator