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Organization
PROVIDENCE THERAPEUTICS, LLC
Active
Organization
PROVIDENCE THERAPEUTICS, LLC
Active
Other names
Providence Therapeutics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONY DUNNING MARTINEZ MD (OWNER)
(401) 935-2067
Entity
Organization
Contact information
Practice address
141 ELM ST APT 3C, BUFFALO, NY 14203-2083
(401) 935-2067
Mailing address
141 ELM ST APT 3C, BUFFALO, NY 14203-2083
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
238099
NY
Other
Enumeration date
10/17/2017
Last updated
10/17/2017
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