Individual
ALYSSA M MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSED
Contact information
Practice address
743 PETER PAUL DR, WEST ISLIP, NY 11795-3535
(631) 383-2460
Mailing address
743 PETER PAUL DR, WEST ISLIP, NY 11795-3535
(631) 383-2460
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
1185807171
NY
Other
Enumeration date
01/15/2021
Last updated
01/15/2021
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