Healthcare Provider Details

I. General information

NPI: 1932622081
Provider Name (Legal Business Name): ALMA ROSA MARTINEZ PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2017
Last Update Date: 01/30/2025
Certification Date: 01/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 WILLIAMSON ST
ELIZABETH NJ
07202-3625
US

IV. Provider business mailing address

283 HOPE AVE FL 2
PASSAIC NJ
07055-6905
US

V. Phone/Fax

Practice location:
  • Phone: 908-994-5422
  • Fax:
Mailing address:
  • Phone: 973-393-7375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number25MP00440300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: