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General NPI Number Information
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NPI Number | 1023047289
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Entity Type | Organization
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Legal Business Name | SUNRISE MEDICAL PC
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Dates
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Enumeration Date | 07/01/2006
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Last Update Date | 01/28/2020
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Provider Practice Location Address
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Address Line | 4039 JUNCTION BLVD
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City | CORONA
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State | NY
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Zip | 11368-2121
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Country | US
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Telephone | 718-397-8866
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Fax |
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Provider Business Mailing Address
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Address Line | 4039 JUNCTION BLVD
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City | CORONA
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State | NY
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Zip | 11368-2121
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Country | US
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Telephone | 718-397-8866
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Fax |
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Authorized Official
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Title or Position | DR
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Name | DR. SERGIO MARTINEZ
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Credential |
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Telephone | 718-397-8866
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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