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General NPI Number Information
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NPI Number | 1982726394
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Entity Type | Individual
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Provider Name | MARTRICE WHITE PA
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Gender | Female
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Dates
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Enumeration Date | 04/05/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3959 BROADWAY
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City | NEW YORK
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State | NY
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Zip | 10032-1559
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Country | US
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Telephone | 212-342-8600
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Fax |
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Provider Business Mailing Address
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Address Line | 1085 JULIA ST
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City | TEANECK
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State | NJ
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Zip | 07666-4832
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Country | US
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Telephone | 201-862-9107
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 0042661
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License Number State | NY
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