Individual
MISS MARY ELLEN MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
1015 W BEECH ST, LONG BEACH, NY 11561-1203
(646) 942-8164
(631) 928-2045
Mailing address
17 MICHIGAN ST, LONG BEACH, NY 11561-1306
(646) 942-8164
(631) 928-2045
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
25002586
NY
Other
Enumeration date
01/19/2007
Last updated
07/08/2007
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