Healthcare Provider Details

I. General information

NPI: 1891877262
Provider Name (Legal Business Name): NAOMI G MARTON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 W 239TH STREET
BRONX NY
10463
US

IV. Provider business mailing address

254 W 98TH ST APARTMENT #3D
NEW YORK NY
10025-5569
US

V. Phone/Fax

Practice location:
  • Phone: 718-601-2280
  • Fax:
Mailing address:
  • Phone: 917-860-2801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number075115
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: