Provider Demographics
NPI:1093110256
Name:MARTINEZ, RAQUEL
Entity type:Individual
Prefix:MS
First Name:RAQUEL
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-5238
Mailing Address - Country:US
Mailing Address - Phone:203-869-4848
Mailing Address - Fax:
Practice Address - Street 1:20 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-5238
Practice Address - Country:US
Practice Address - Phone:203-869-4848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-30
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker