Individual
TRACY L MARTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1138 BROADWAY ST, ELMIRA, NY 14904-2502
(607) 734-7982
(607) 734-1953
Mailing address
571 SAINT JOSEPHS BLVD FL 2, ELMIRA, NY 14901-3230
(607) 271-2050
(607) 873-1244
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
343830
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05672046
—
NY
05
—
102951190
—
PA
Enumeration date
06/26/2006
Last updated
11/25/2020
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