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General NPI Number Information
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NPI Number | 1255757134
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Entity Type | Individual
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Provider Name | LYUDMILA MAGAKYAN-MARTINEZ NP
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Gender | Female
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Dates
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Enumeration Date | 03/15/2014
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Last Update Date | 03/17/2014
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Provider Practice Location Address
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Address Line | 77 PARK AVE
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City | NEW YORK
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State | NY
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Zip | 10016-2556
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Country | US
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Telephone | 212-826-6999
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Fax |
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Provider Business Mailing Address
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Address Line | 34 VENTURA CT
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City | OLD BRIDGE
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State | NJ
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Zip | 08857-3051
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Country | US
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Telephone | 646-479-5638
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 338629
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 338629
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License Number State | NY
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