Individual
ALTAGRACIA MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
9729 64TH RD, REGO PARK, NY 11374-2259
(718) 896-3400
(718) 459-5621
Mailing address
406 E 161ST ST, APT 9K, BRONX, NY 10451-4173
(718) 666-6987
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00244019
—
NY
Enumeration date
02/06/2013
Last updated
02/06/2013
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