Doctor Name: | MS. JOANNE RYAN MARTIN |
NPI Number: | 1194995985 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | 381468 |
Business Practice Address: | 27 Liberty Square Mall Stony Point, NY - 109802400 |
Business Phone Number: | 8454296900 |
Business Fax Number: | 8454297050 |
Mailing Address: | 27 Liberty Square Mall, STONY POINT |
State: | NY |
Postal Code: | 109802400 |
Phone Number: | 8454296900 |
Fax Number: | 8454297050 |
NPI Enumeration Date: | 03/07/2008 |
NPI Last Update Date: | 03/07/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0200X |
License Number: | 381468 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |