Individual
ROBERTA MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
1000 S MERCER ST, 4TH FLOOR, NEW CASTLE, PA 16101-4672
(724) 658-4688
(724) 658-8810
Mailing address
1000 S. MERCER STREET, 4TH FLOOR, NEW CASTLE, PA 16101-4572
(724) 658-4688
(724) 658-8810
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
RN502257L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1016551700001
—
PA
Enumeration date
03/26/2007
Last updated
07/09/2007
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