Individual
ELEECE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
29-76 NORTHERN BLVD, LONG ISLAND CITY, NY 11101
(347) 510-3654
Mailing address
825 GERARD AVE, BRONX, NY 10451-2342
(646) 208-1801
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02740141
—
NY
Enumeration date
08/20/2008
Last updated
08/20/2008
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