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General NPI Number Information
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NPI Number | 1760205645
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Entity Type | Organization
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Legal Business Name | MARTIN NEUROPSYCHOLOGY PLLC
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Dates
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Enumeration Date | 11/07/2024
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Last Update Date | 11/07/2024
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Provider Practice Location Address
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Address Line | 10 MAXWELL DR STE 205
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City | CLIFTON PARK
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State | NY
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Zip | 12065-2933
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Country | US
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Telephone | 518-288-7156
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Fax | 518-309-7838
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Provider Business Mailing Address
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Address Line | 10 MAXWELL DR STE 205
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City | CLIFTON PARK
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State | NY
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Zip | 12065-2933
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Country | US
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Telephone | 518-288-7156
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. REBECCA MARTIN
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Credential | PHD
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Telephone | 518-288-7156
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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