Healthcare Provider Details

I. General information

NPI: 1447184007
Provider Name (Legal Business Name): SYDNEY MARTIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4567 E 9TH AVE
DENVER CO
80220-3908
US

IV. Provider business mailing address

550 E 19TH AVE UNIT 2517
DENVER CO
80203-1339
US

V. Phone/Fax

Practice location:
  • Phone: 303-320-2455
  • Fax:
Mailing address:
  • Phone: 720-371-6765
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License NumberQ212210
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: