Individual
THERESA MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS ED
Contact information
Practice address
409 42ND STREET, UNION CITY, NJ 07087-4917
(551) 689-9638
Mailing address
409 42ND STREET, UNION CITY, NJ 07087-4917
(551) 689-9638
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
540983
NJ
Other
Enumeration date
06/08/2012
Last updated
06/08/2012
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