Provider Demographics
NPI:1720120207
Name:CARLOS JAVIER MARTINEZ, O.D., P.C.
Entity Type:Organization
Organization Name:CARLOS JAVIER MARTINEZ, O.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:JAVIER
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:732-748-9001
Mailing Address - Street 1:16 MAIDEN LN
Mailing Address - Street 2:
Mailing Address - City:BOUND BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:08805-2024
Mailing Address - Country:US
Mailing Address - Phone:732-748-9001
Mailing Address - Fax:732-369-6313
Practice Address - Street 1:16 MAIDEN LN
Practice Address - Street 2:
Practice Address - City:BOUND BROOK
Practice Address - State:NJ
Practice Address - Zip Code:08805-2024
Practice Address - Country:US
Practice Address - Phone:732-748-9001
Practice Address - Fax:732-369-6450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ270A00490200152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ583221Medicare PIN