MEDICARE: DR. NILSA MILAGROS MARTINEZ MD

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	207Q00000X	Family Medicine Physician	202674	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000525840005	OTHER	NY	COMMUNITY BLUE / WNY BCBS
2	5923565	OTHER	NY	AETNA
3	115976BF	OTHER	NY	PREFERRED CARE
4	P020202674	OTHER	NY	BLUE CROSS BLUE SHIELD
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	P010202674	OTHER	NY	BLUE CHOICE

General Provider Information

NPI Number	:	1215929187
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NILSA MILAGROS MARTINEZ MD

Provider Business Mailing Address
First Line	:	279 EAST AVE
Second Line	:
City	:	HILTON
State	:	NY
Zip	:	14468-1333
Country	:	US
Telephone Number	:	585-392-9100
Fax Number	:	585-392-6292

Provider Business Practice Location Address
First Line	:	279 EAST AVE
Second Line	:
City	:	HILTON
State	:	NY
Zip	:	14468-1333
Country	:	US
Telephone Number	:	585-392-9100
Fax Number	:	585-392-6292

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2005
Last Update Date	:	06/19/2019

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