Individual provider · Type 1 NPI
Martin Martinicky
Acute Care Nurse Practitioner · Jericho, NY
NPI number
1417630302
Active
Practice location
61 Jericho Tpke
Jericho, NY 11753-1051
Fax (516) 362-3939
Mailing address
9972 66th Rd Apt 7D
Rego Park, NY 11374-4443
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Acute Care Nurse Practitioner Primary | 363LA2100X | 432741 (NY) |
Acute Care Nurse Practitioner: Definition to come...
About NPI 1417630302
Martin Martinicky's National Provider Identifier is 1417630302, issued on Aug 8, 2023. The primary taxonomy on file is Acute Care Nurse Practitioner (363LA2100X), and the practice location is in Jericho, NY. The record was last updated on Aug 8, 2023.