Individual
CAROLA JEANNETTE MARTINEZ-VAN BOKKEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
301 FRONT ST, NYACK, NY 10960-1405
(917) 288-9546
Mailing address
301 FRONT ST, NYACK, NY 10960-1405
(917) 288-9546
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1435498201
NY
Other
Enumeration date
10/04/2021
Last updated
10/04/2021
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