Organization
TERI MARTIN FAMILY NURSE PRACTITIONER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERI ANN MARTIN FNP (OWNER)
(518) 852-5847
Entity
Organization
Contact information
Practice address
10 NORTH RIDGE EXTENSION, WINDHAM, NY 12496-0794
(518) 852-5847
Mailing address
10 NORTH RIDGE EXTENSION, PO BOX 794, WINDHAM, NY 12496-0794
(518) 852-5847
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
330978
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02093850
—
NY
Enumeration date
07/11/2014
Last updated
07/11/2014
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