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General NPI Number Information
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NPI Number | 1922148915
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Entity Type | Individual
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Provider Name | DR. MARGUERITE MARTIN
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Gender | Female
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 208 WICKHAM AVE
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City | MIDDLETOWN
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State | NY
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Zip | 10940-3801
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Country | US
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Telephone | 646-285-4322
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Fax | 845-386-6710
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Provider Business Mailing Address
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Address Line | 12 CENTRAL AVE
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City | NEWBURGH
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State | NY
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Zip | 12550-3525
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Country | US
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Telephone | 646-285-4322
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Fax | 845-386-6710
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 0131551
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License Number State | NY
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