Individual
DR. TARA DAWN MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2171 JERICHO TPKE STE 100, COMMACK, NY 11725-2900
(631) 486-5030
(631) 486-2694
Mailing address
2171 JERICHO TPKE STE 100, COMMACK, NY 11725-2900
(631) 486-5030
(631) 724-4229
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
267602
NY
208C00000X
Colon & Rectal Surgery Physician
Primary
267602
NY
208C00000X
Colon & Rectal Surgery Physician
OS16564
FL
Other
Enumeration date
08/06/2007
Last updated
04/21/2022
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