MEDICARE: CHELSEA 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	106E00000X	Assistant Behavior Analyst
2	2355S0801X	Speech-Language Assistant

General Provider Information

NPI Number	:	1972322832
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHELSEA MARTINEZ

Provider Business Mailing Address
First Line	:	7 KWIECINSKI ST
Second Line	:
City	:	WEST HAVERSTRAW
State	:	NY
Zip	:	10993-1410
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1925 SCHIEFFELIN AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10466-5605
Country	:	US
Telephone Number	:	718-654-6377
Fax Number	:

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

Provider Enumeration Date	:	10/08/2024
Last Update Date	:	10/09/2024

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Directions to “ CHELSEA MARTINEZ ” Practice Location

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