Healthcare Provider Details

I. General information

NPI: 1023937927
Provider Name (Legal Business Name): TIARA MARTINEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4904 DENBIGH CT
MAYS LANDING NJ
08330-2610
US

IV. Provider business mailing address

4904 DENBIGH CT
MAYS LANDING NJ
08330-2610
US

V. Phone/Fax

Practice location:
  • Phone: 609-389-4635
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: