Provider Demographics
NPI:1558107243
Name:MARTINEZ, BESAIRA ELVIRA
Entity type:Individual
Prefix:MS
First Name:BESAIRA
Middle Name:ELVIRA
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 1:735 PELHAM PKWY N
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-9507
Mailing Address - Country:US
Mailing Address - Phone:347-208-4846
Mailing Address - Fax:
Practice Address - Street 1:735 PELHAM PKWY N APT 5T
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-9525
Practice Address - Country:US
Practice Address - Phone:929-469-9407
Practice Address - Fax:347-208-4845
Is Sole Proprietor?:No
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker