Individual
SHATASHA MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
801 E 241ST ST, BRONX, NY 10470-1303
(718) 671-2100
Mailing address
3400 BAINBRIDGE AVE FL 5, BRONX, NY 10467-2404
(718) 920-5864
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
746738
NY
363L00000X
Nurse Practitioner
Primary
F348548
NY
Other
Enumeration date
04/12/2018
Last updated
03/28/2022
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