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NPI Code Detail

MEDICARE: MR. RENE MARTINEZ LMSW,CASAC

MEDICARE: MR. RENE MARTINEZ LMSW,CASAC
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
1101YA0400XAddiction (Substance Use Disorder) Counselor7584NY
2104100000XSocial WorkerP65334NY

General Provider Information

NPI Number : 1033374871
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RENE MARTINEZ LMSW,CASAC
Provider Business Mailing Address
First Line : 1285 ROCKAWAY AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11236-2330
Country : US
Telephone Number : 718-257-3195
Fax Number : 718-257-1162
Provider Business Practice Location Address
First Line : 1285 ROCKAWAY AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11236-2330
Country : US
Telephone Number : 718-257-3195
Fax Number : 718-257-1162
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2008
Last Update Date : 07/23/2008

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