Healthcare Provider Details

I. General information

NPI: 1740196807
Provider Name (Legal Business Name): MAYRA GISELL MARTINEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

256 CHAPMAN RD
NEWARK DE
19702-5499
US

IV. Provider business mailing address

13 BURNS WAY
NEWARK DE
19702-5328
US

V. Phone/Fax

Practice location:
  • Phone: 302-292-1334
  • Fax:
Mailing address:
  • Phone: 302-521-3661
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080C0008X
TaxonomyChild Abuse Pediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: