Healthcare Provider Details

I. General information

NPI: 1497430946
Provider Name (Legal Business Name): NUBIA CISNEROS-MARTINEZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2023
Last Update Date: 06/21/2023
Certification Date: 06/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

645 PENN ST FL 2
READING PA
19601-3543
US

IV. Provider business mailing address

645 PENN ST FL 2
READING PA
19601-3543
US

V. Phone/Fax

Practice location:
  • Phone: 610-373-4281
  • Fax: 610-898-1611
Mailing address:
  • Phone: 610-373-4281
  • Fax: 610-898-1611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN734141
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: