Healthcare Provider Details

I. General information

NPI: 1699679126
Provider Name (Legal Business Name): CATINA MARTINEZ MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67 GREENWOOD RD # TD
BAY SHORE NY
11706-5024
US

IV. Provider business mailing address

3739 LIBBY LN
WANTAGH NY
11793-1418
US

V. Phone/Fax

Practice location:
  • Phone: 631-647-9577
  • Fax:
Mailing address:
  • Phone: 516-406-2940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number053348
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: