Provider Demographics
NPI:1801925441
Name:MARTINEZ, ELSA I (OD)
Entity type:Individual
Prefix:DR
First Name:ELSA
Middle Name:I
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:ELSA
Other - Middle Name:I
Other - Last Name:MARTINEZ-RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:8614 WESTWOOD CENTER DR FL 9
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2442
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2842 S EAGLE RD
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-1543
Practice Address - Country:US
Practice Address - Phone:215-579-1155
Practice Address - Fax:215-504-8076
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001096152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist