Healthcare Provider Details

I. General information

NPI: 1902078868
Provider Name (Legal Business Name): FRANCISCO A MARTINEZ PEDIATRICS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2008
Last Update Date: 03/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 W MERRICK RD
FREEPORT NY
11520-3826
US

IV. Provider business mailing address

63 HUNGRY HARBOR RD
VALLEY STREAM NY
11581-2510
US

V. Phone/Fax

Practice location:
  • Phone: 516-223-3195
  • Fax: 516-223-3196
Mailing address:
  • Phone: 516-223-3195
  • Fax: 516-291-6209

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number209764
License Number StateNY

VIII. Authorized Official

Name: DR. FRANCISCO A MARTINEZ
Title or Position: OWNER
Credential: M.D.
Phone: 516-223-3195