| Doctor Name: | MS. SUSAN ANTONINA MARTINO |
| NPI Number: | 1609051879 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NURSE PRACTITIONER |
| License Number: | F3045551 |
| Business Practice Address: | 19 Laurel Ave Palliative Care Cornwall, NY - 125181403 |
| Business Phone Number: | 8454584500 |
| Business Fax Number: | 8454584808 |
| Mailing Address: | 19 Laurel Ave, Business Office CORNWALL |
| State: | NY |
| Postal Code: | 125181403 |
| Phone Number: | 8454584958 |
| Fax Number: | 8454584970 |
| NPI Enumeration Date: | 01/07/2008 |
| NPI Last Update Date: | 05/07/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | F3045551 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |