Elizabeth S Martinez, LMT
Individual provider Active NPI Specialist · Laguna, NM
NPI 1104058494 · NPPES record last updated Aug 20, 2009
Key facts
- NPI
- 1104058494
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 4067 (NM)
- Practice address
- HC 77 Box 271
Laguna, NM 87026-9704 - Phone
- (505) 918-6270
- NPI assigned
- Aug 20, 2009
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4067 | NM | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 4067 | NM | Yes |
Addresses
Primary practice location
HC 77 Box 271
Laguna, NM 87026-9704
Mailing address
HC 77 Box 271
Laguna, NM 87026-9704
Phone (505) 918-6270
Other providers in Laguna, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 20, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.