MEDICARE: SAUL MARTINEZ

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	1041C0700X	Clinical Social Worker	089658	NY

General Provider Information

NPI Number	:	1497280135
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAUL MARTINEZ

Provider Business Mailing Address
First Line	:	6767 BURNS ST
Second Line	:	APT 5J
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-3555
Country	:	US
Telephone Number	:	917-287-1235
Fax Number	:

Provider Business Practice Location Address
First Line	:	6767 BURNS ST
Second Line	:	APT 5J
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-3555
Country	:	US
Telephone Number	:	917-287-1235
Fax Number	:

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

Provider Enumeration Date	:	05/01/2017
Last Update Date	:	05/01/2017

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Directions to “ SAUL MARTINEZ ” Practice Location

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