MEDICARE: VANESSA ANNE 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	163W00000X	Registered Nurse	608647	NY

General Provider Information

NPI Number	:	1598608127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VANESSA ANNE MARTINEZ

Provider Business Mailing Address
First Line	:	4900 BROAD RD
Second Line	:
City	:	SYRACUSE
State	:	NY
Zip	:	13215-2265
Country	:	US
Telephone Number	:	315-492-5011
Fax Number	:

Provider Business Practice Location Address
First Line	:	5000 BRITTONFIELD PKWY
Second Line	:
City	:	EAST SYRACUSE
State	:	NY
Zip	:	13057-9226
Country	:	US
Telephone Number	:	315-362-5129
Fax Number	:	315-362-5179

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

Provider Enumeration Date	:	04/09/2026
Last Update Date	:	05/18/2026

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Directions to “ VANESSA ANNE MARTINEZ ” Practice Location

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