Individual
BEVERLY ANN MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1 CHIMNEY POINT DR, OGDENSBURG, NY 13669-2212
(315) 541-2001
Mailing address
26 PEARL ST, GOUVERNEUR, NY 13642-1320
(315) 276-9159
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
556938
NY
Other
Enumeration date
06/12/2024
Last updated
06/12/2024
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