Individual
TERRISSA CORETTA MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
20 EAST MAIN STREET, MARATHON, NY 13803
(607) 849-3271
(607) 849-6357
Mailing address
85 SOUTH WEST STREET, HOMER, NY 13077
(607) 753-3797
(607) 753-6677
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
261220-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03759579
—
NY
Enumeration date
06/20/2011
Last updated
04/28/2022
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