Provider Demographics
NPI:1427771989
Name:MARTE, LISBETH
Entity type:Individual
Prefix:
First Name:LISBETH
Middle Name:
Last Name:MARTE
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 1:3548 TRYON AVE APT 4C
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-1567
Mailing Address - Country:US
Mailing Address - Phone:646-673-6413
Mailing Address - Fax:
Practice Address - Street 1:93 NAGLE AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10040-1438
Practice Address - Country:US
Practice Address - Phone:212-567-5456
Practice Address - Fax:212-942-6319
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-20
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032360235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist