=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942254297
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOSEPH A MARTINEZ MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/20/2006
-----------------------------------------------------
Last Update Date | 10/11/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 305 SEVENTH ST
-----------------------------------------------------
City | NEW KENSINGTON
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15068-6529
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 724-339-3900
-----------------------------------------------------
Fax | 724-334-1704
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 305 SEVENTH ST
-----------------------------------------------------
City | NEW KENSINGTON
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15068-6529
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 724-339-3900
-----------------------------------------------------
Fax | 724-334-1704
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 16282
-----------------------------------------------------
License Number State | NH
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | MD16579
-----------------------------------------------------
License Number State | ME
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | MD463426
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------