Healthcare Provider Details

I. General information

NPI: 1295367829
Provider Name (Legal Business Name): MAYRA A ALEY MARTINEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/11/2020
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

888 EASTON AVE
SOMERSET NJ
08873-1898
US

IV. Provider business mailing address

888 EASTON AVE
SOMERSET NJ
08873-1898
US

V. Phone/Fax

Practice location:
  • Phone: 849-800-8519
  • Fax:
Mailing address:
  • Phone: 849-800-8519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-2838336
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: