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NPI Code Detail

MEDICARE: CYNTHIA MARTINEZ LMSW

MEDICARE:   CYNTHIA  MARTINEZ  LMSW
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
1104100000XSocial Worker4722CT

General Provider Information

NPI Number : 1104475060
Entity Type Code : Individual
Provider Name (Legal Business Name) : CYNTHIA MARTINEZ LMSW
Provider Business Mailing Address
First Line : 46 ALBION ST
Second Line :
City : BRIDGEPORT
State : CT
Zip : 06605-2602
Country : US
Telephone Number : 203-330-6000
Fax Number :
Provider Business Practice Location Address
First Line : 743 SOUTH AVE
Second Line :
City : BRIDGEPORT
State : CT
Zip : 06604-5810
Country : US
Telephone Number : 203-330-6010
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/04/2019
Last Update Date : 09/04/2019

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Directions to “ CYNTHIA MARTINEZ LMSW” Practice Location

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