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General NPI Number Information
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NPI Number | 1861721920
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Entity Type | Individual
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Provider Name | KRISTIN MARTINEZ
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Gender | Female
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Dates
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Enumeration Date | 12/18/2009
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Last Update Date | 12/18/2009
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Provider Practice Location Address
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Address Line | 2250 S SEAMANS NECK RD
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City | SEAFORD
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State | NY
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Zip | 11783-3253
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Country | US
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Telephone | 516-781-3712
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Fax |
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Provider Business Mailing Address
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Address Line | 7940 261ST ST
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City | FLORAL PARK
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State | NY
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Zip | 11004-1319
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Country | US
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Telephone | 718-343-3103
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 053859
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License Number State | NY
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