MEDICARE: SUNRISE MEDICAL PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RP1001X	Pulmonary Disease Physician

General Provider Information

NPI Number	:	1023047289
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNRISE MEDICAL PC

Provider Business Mailing Address
First Line	:	4039 JUNCTION BLVD
Second Line	:
City	:	CORONA
State	:	NY
Zip	:	11368-2121
Country	:	US
Telephone Number	:	718-397-8866
Fax Number	:

Provider Business Practice Location Address
First Line	:	4039 JUNCTION BLVD
Second Line	:
City	:	CORONA
State	:	NY
Zip	:	11368-2121
Country	:	US
Telephone Number	:	718-397-8866
Fax Number	:

Authorized Official
Title or Position	:	DR
Name	:	DR. SERGIO MARTINEZ
Credential	:
Telephone Number	:	718-397-8866

Provider Enumeration Date	:	07/01/2006
Last Update Date	:	01/28/2020

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Directions to “SUNRISE MEDICAL PC ” Practice Location

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