Individual
CAMILLE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5 GILDARE DRIVE, EAST NORTHPORT, NY 11731
(631) 759-1150
Mailing address
5 GILDARE DR, EAST NORTHPORT, NY 11731-3222
(631) 759-1150
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
693064
NY
Other
Enumeration date
05/09/2016
Last updated
05/09/2016
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