Provider Demographics
NPI:1215929187
Name:MARTINEZ, NILSA MILAGROS (MD)
Entity type:Individual
Prefix:DR
First Name:NILSA
Middle Name:MILAGROS
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:279 EAST AVE
Mailing Address - Street 2:
Mailing Address - City:HILTON
Mailing Address - State:NY
Mailing Address - Zip Code:14468-1333
Mailing Address - Country:US
Mailing Address - Phone:585-392-9100
Mailing Address - Fax:585-392-6292
Practice Address - Street 1:279 EAST AVE
Practice Address - Street 2:
Practice Address - City:HILTON
Practice Address - State:NY
Practice Address - Zip Code:14468-1333
Practice Address - Country:US
Practice Address - Phone:585-392-9100
Practice Address - Fax:585-392-6292
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY202674207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000525840005OtherCOMMUNITY BLUE / WNY BCBS
NY5923565OtherAETNA
NY115976BFOtherPREFERRED CARE
NYP020202674OtherBLUE CROSS BLUE SHIELD
NY01770685Medicaid
NYP010202674OtherBLUE CHOICE
NY5923565OtherAETNA
NY000525840005OtherCOMMUNITY BLUE / WNY BCBS