Provider Demographics
NPI:1306513783
Name:MARTINEZ, MICHELE (RPH)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 HAMILTON LN
Mailing Address - Street 2:
Mailing Address - City:PLAINSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08536-1125
Mailing Address - Country:US
Mailing Address - Phone:609-213-2732
Mailing Address - Fax:
Practice Address - Street 1:37 HAMILTON LN
Practice Address - Street 2:
Practice Address - City:PLAINSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08536-1125
Practice Address - Country:US
Practice Address - Phone:609-213-2732
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI1674400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist