| Doctor Name: | MISS IVETTE AMNERYS MARTINEZ |
| NPI Number: | 1104296524 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 26NJ00591600 |
| Business Practice Address: | 600 Pemberton Browns-mill Road Pemberton, NJ - 080680248 |
| Business Phone Number: | 6098941100 |
| Business Fax Number: | 6098941110 |
| Mailing Address: | 1 N White Horse Pike, HAMMONTON |
| State: | NJ |
| Postal Code: | 080371875 |
| Phone Number: | 6095670434 |
| Fax Number: | 6095671169 |
| NPI Enumeration Date: | 09/28/2015 |
| NPI Last Update Date: | 02/10/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 26NJ00591600 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |