Individual
MR. MIGUEL MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
36 WALLACE AVE, AUBURN, NY 13021-3116
(315) 916-3005
Mailing address
36 WALLACE AVE, AUBURN, NY 13021-3116
(315) 916-3005
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
980299314
NY
Other
Enumeration date
12/30/2022
Last updated
12/30/2022
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