Individual
MRS. MARY ELIZABETH MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
595 W MAIN ST, WATERTOWN, NY 13601-1335
(315) 888-2228
Mailing address
463 SCOTT RD, SANDY CREEK, NY 13145-2154
(315) 387-6683
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
843451
NY
164W00000X
Licensed Practical Nurse
260901
NY
Other
Enumeration date
11/28/2006
Last updated
07/30/2023
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