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General NPI Number Information
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NPI Number | 1235314303
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Entity Type | Organization
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Legal Business Name | WENDY E MARTIN
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Dates
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Enumeration Date | 01/08/2008
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 525 FRENCH RD. CONMED HEALTH CENTER
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City | UTICA
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State | NY
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Zip | 13502
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Country | US
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Telephone | 315-624-3491
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Fax | 315-624-3478
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Provider Business Mailing Address
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Address Line | 8736 S MAIN ST
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City | POLAND
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State | NY
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Zip | 13431-2305
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Country | US
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Telephone | 315-624-3491
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Fax | 315-624-3478
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Authorized Official
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Title or Position | ADULT NURSE PRACTITIONER
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Name | MRS. WENDY EVELYN MARTIN
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Credential | RN MSN ANP
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Telephone | 315-895-4050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | F302575
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License Number State | NY
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