Individual
MS. KATIS MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
525 E 68TH ST STE J-130, NEW YORK, NY 10065-4870
(212) 746-0315
Mailing address
1826 GORMLEY AVE, MERRICK, NY 11566-3009
(516) 236-8241
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
012076
NY
Other
Enumeration date
09/06/2007
Last updated
11/02/2017
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