Individual
MS. MARY KATHLEEN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
31 MAIN RD, RIVERHEAD, NY 11901-1953
(631) 722-4400
(631) 722-4426
Mailing address
21 W 2ND ST, STE 11, RIVERHEAD, NY 11901-2752
(631) 722-4400
(631) 722-4426
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F305471
NY
Other
Enumeration date
10/15/2010
Last updated
01/13/2017
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