MEDICARE: MRS. JOYCE MARTINEZ REGISTERED NURSE

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	163WA2000X	Administrator Registered Nurse	389289-1	NY

General Provider Information

NPI Number	:	1932747128
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JOYCE MARTINEZ REGISTERED NURSE

Provider Business Mailing Address
First Line	:	195 ELM AVE
Second Line	:
City	:	TEANECK
State	:	NJ
Zip	:	07666-2321
Country	:	US
Telephone Number	:	201-281-5132
Fax Number	:

Provider Business Practice Location Address
First Line	:	WARDS ISLAND COMPLEX
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10035-6095
Country	:	US
Telephone Number	:	646-672-5806
Fax Number	:

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

Provider Enumeration Date	:	12/18/2019
Last Update Date	:	12/18/2019

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