MEDICARE: DR. SERGIO MARTINEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RP1001X	Pulmonary Disease Physician	181742	NY

General Provider Information

NPI Number	:	1336171040
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SERGIO MARTINEZ

Provider Business Mailing Address
First Line	:	2540 SHORE BLVD
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11102-3941
Country	:	US
Telephone Number	:	718-446-4544
Fax Number	:

Provider Business Practice Location Address
First Line	:	3711 88TH ST
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-7630
Country	:	US
Telephone Number	:	718-446-4544
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	11/20/2007

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Directions to “ DR. SERGIO MARTINEZ ” Practice Location

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