| Doctor Name: | REBECCA MARTIN |
| NPI Number: | 1003286881 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | F340055 |
| Business Practice Address: | 112 Kimball Ave Penn Yan, NY - 145271816 |
| Business Phone Number: | 3155319102 |
| Business Fax Number: | 3155319103 |
| Mailing Address: | Po Box 423, 14 Maiden Lane PENN YAN |
| State: | NY |
| Postal Code: | 145270423 |
| Phone Number: | 3155319102 |
| Fax Number: | 3155319103 |
| NPI Enumeration Date: | 10/06/2015 |
| NPI Last Update Date: | 05/13/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | F340055 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |