Provider Demographics
NPI:1992098677
Name:MARTIN, LORRAINE E (RN,BSN CDE)
Entity type:Individual
Prefix:MS
First Name:LORRAINE
Middle Name:E
Last Name:MARTIN
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Gender:F
Credentials:RN,BSN CDE
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Mailing Address - Street 1:47 NEW SCOTLAND AVE
Mailing Address - Street 2:MC 88
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3412
Mailing Address - Country:US
Mailing Address - Phone:518-262-5723
Mailing Address - Fax:518-262-4974
Practice Address - Street 1:47 NEW SCOTLAND AVE
Practice Address - Street 2:MC 88
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3412
Practice Address - Country:US
Practice Address - Phone:518-262-5723
Practice Address - Fax:518-262-4974
Is Sole Proprietor?:No
Enumeration Date:2011-05-27
Last Update Date:2011-05-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY309660 1163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator