Individual
QAMMARAH MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
1065 SOUTHERN BLVD, BRONX, NY 10459-2417
(718) 589-2440
Mailing address
1065 SOUTHERN BLVD, BRONX, NY 10459-2417
(718) 589-2440
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
723175
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
382834
NY
Other
Enumeration date
06/20/2017
Last updated
04/30/2018
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