TERI MARTIN FAMILY NURSE PRACTITIONER PC


Address: 10 North Ridge Extension, Windham, NY 12496-0794
Phone: 5188525847

TERI MARTIN FAMILY NURSE PRACTITIONER PC (NPI# 1245647189) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1245647189
Entity Type Organization
Organization Name TERI MARTIN FAMILY NURSE PRACTITIONER PC
Practice Address 10 North Ridge Extension
Windham
NY 12496-0794
Mailing Address 10 North Ridge Extension
Po Box 794
Windham
NY 12496-0794
Practice Telephone 5188525847
Mailing Telephone 5188525847
Enumeration Date 2014-07-11
Last Update Date 2014-07-11
Authorized Official Name TERI ANN MARTIN (OWNER)
Authorized Official Telephone 5188525847
Authorized Official Credential FNP
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QP2300X Clinic/Center
Specialization: Primary Care
330978 NY Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
NY 02093850 05

Office Location

Street Address 10 NORTH RIDGE EXTENSION
City WINDHAM
State NY
Zip Code 12496-0794

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Taxonomy Information

Taxonomy Code 261QP2300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Primary Care

Taxonomy Definition

Definition to come...

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Competitor

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City WINDHAM
Zip Code 12496

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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