Healthcare Provider Details

I. General information

NPI: 1780922377
Provider Name (Legal Business Name): RAQUEL MARTINEZ-ALZATE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2013
Last Update Date: 11/07/2025
Certification Date: 11/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

860 S WHITE HORSE PIKE
HAMMONTON NJ
08037-2018
US

IV. Provider business mailing address

1 N WHITE HORSE PIKE
HAMMONTON NJ
08037-1875
US

V. Phone/Fax

Practice location:
  • Phone: 469-257-3500
  • Fax: 609-567-1951
Mailing address:
  • Phone: 469-257-3500
  • Fax: 609-567-1169

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ00433600
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NJ00433600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: