Individual
EMANUEL MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
104 COLUMBUS DR, TENAFLY, NJ 07670-1634
(646) 258-9463
Mailing address
104 COLUMBUS DR, TENAFLY, NJ 07670-1634
(646) 258-9463
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
011093-1
NY
363A00000X
Physician Assistant
Primary
25MP00510800
NJ
Other
Enumeration date
02/07/2007
Last updated
11/04/2024
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