| Doctor Name: | MRS. SHANAZ MARTIN |
| NPI Number: | 1508100231 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT, LNHA |
| License Number: | 022493-1 |
| Business Practice Address: | 301 Sicomac Ave Wyckoff, NJ - 074812159 |
| Business Phone Number: | 2018484323 |
| Business Fax Number: | |
| Mailing Address: | 15 Lorrie Ln, WANAQUE |
| State: | NJ |
| Postal Code: | 074651104 |
| Phone Number: | 9739863014 |
| Fax Number: | 2018484259 |
| NPI Enumeration Date: | 11/19/2012 |
| NPI Last Update Date: | 11/19/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 022493-1 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |