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General NPI Number Information
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NPI Number | 1205495728
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Entity Type | Individual
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Provider Name | DAISY A MARTY PLACENCIA MD
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Gender | Female
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Dates
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Enumeration Date | 06/08/2019
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Last Update Date | 06/19/2025
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Provider Practice Location Address
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Address Line | 1945 STATE ROUTE 33
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City | NEPTUNE
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State | NJ
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Zip | 07753-4859
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Country | US
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Telephone | 732-776-4283
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Fax | 732-776-4639
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Provider Business Mailing Address
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Address Line | 2160 S 1ST AVE
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City | MAYWOOD
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State | IL
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Zip | 60153-3328
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 036160476
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 036.160476
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 25MA12635900
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License Number State | NJ
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