Provider Demographics
NPI:1588096424
Name:MARTINEZ, EDWARD ANTHONY (FNP-BC, NP-C)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:ANTHONY
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:FNP-BC, NP-C
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Mailing Address - Street 1:462 1ST AVE
Mailing Address - Street 2:11E2 ANESTHESIOLOGY DEPARTMENT
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-9196
Mailing Address - Country:US
Mailing Address - Phone:212-562-6511
Mailing Address - Fax:212-263-8643
Practice Address - Street 1:462 1ST AVE
Practice Address - Street 2:ANESTHESIOLOGY DEPARTMENT 11E2 11TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-9196
Practice Address - Country:US
Practice Address - Phone:212-562-6577
Practice Address - Fax:212-263-8643
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-02
Last Update Date:2013-08-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY338072363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily