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General NPI Number Information
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NPI Number | 1821939042
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Entity Type | Individual
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Provider Name | JAZLYNN MARTINEZ
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Gender |
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Dates
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Enumeration Date | 04/02/2026
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Last Update Date | 04/02/2026
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Provider Practice Location Address
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Address Line | 10 GOVE ST
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City | EAST BOSTON
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State | MA
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Zip | 02128-1920
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Country | US
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Telephone | 617-568-4401
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Fax |
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Provider Business Mailing Address
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Address Line | 116 CAMPBELL AVE APT 2
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City | REVERE
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State | MA
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Zip | 02151-3509
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 10011049
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License Number State | MA
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