Marietta Felicia Martin, R.N

Primary specialty

Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X

License

360323 Issued in NY

Practice address

2209 Brookwood LN
East Patchogue, NY 11772-7109

Phone

(631) 394-1970

Fax

(631) 394-1970

NPI assigned

Jul 14, 2016

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1468454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468454400000",
    "number": "1235582255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2209 BROOKWOOD LN",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117727109",
            "telephone_number": "631-394-1970",
            "fax_number": "631-394-1970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2209 BROOKWOOD LN",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117727109",
            "telephone_number": "631-394-1970",
            "fax_number": "631-394-1970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "MARIETTA",
        "middle_name": "FELICIA",
        "name_prefix": "Ms.",
        "credential": "R.N",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-14",
        "last_updated": "2016-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "NY",
            "license": "360323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David P Mangiameli, MD
• Eric M Manoff, MD
• James Vito Maone, PT
• Mark S. Vogel
• Helen Martensen, RN
• Lisa Joy Marx, D.O.
• Nirmal Masih, RN
• Jeanna Masone, ANP
• Rachel Masullo, OTR/L
• Wendy Patricia Mayce, MA

• Adult Psychiatric/Mental Health Registered Nurse in East Patchogue, NY
• Providers in East Patchogue, NY by specialty
• Adult Psychiatric/Mental Health Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.