Individual
ANGELY MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
28 KIRK STREET, METHUEN, MA 01844
(978) 876-5338
Mailing address
28 KIRK ST, METHUEN, MA 01844-4349
(978) 876-5338
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100214414805
MASSHEALTH
MA
01
—
986689351
BLUECROSS BLUESHIELD
MA
Enumeration date
04/04/2018
Last updated
04/04/2018
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