Individual
WANDA MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
165 BROOKSIDE AVE, BRIDGEPORT, CT 06606-1502
(203) 683-8377
Mailing address
165 BROOKSIDE AVE, BRIDGEPORT, CT 06606-1502
(203) 683-8377
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
0013007
—
Other
Enumeration date
02/03/2015
Last updated
02/03/2015
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