MEDICARE: SABRINA MARTINEZ ANTHONY PMHNP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	405967	NY
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	26NJ15068300	NJ

General Provider Information

NPI Number	:	1831947191
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SABRINA MARTINEZ ANTHONY PMHNP

Provider Business Mailing Address
First Line	:	3411 VERNON BLVD
Second Line	:
City	:	ASTORIA
State	:	NY
Zip	:	11106-5121
Country	:	US
Telephone Number	:	929-273-0842
Fax Number	:

Provider Business Practice Location Address
First Line	:	3411 VERNON BLVD
Second Line	:
City	:	ASTORIA
State	:	NY
Zip	:	11106-5121
Country	:	US
Telephone Number	:	347-630-8401
Fax Number	:

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

Provider Enumeration Date	:	05/10/2024
Last Update Date	:	04/25/2025

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