Teri Martin Family Nurse Practitioner PC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

330978 Issued in NY

Legal business name

TERI MARTIN FAMILY NURSE PRACTITIONER PC

Practice address

10 North Ridge Extension
Windham, NY 12496-0794

Phone

(518) 852-5847

NPI assigned

Jul 11, 2014

Last updated

Jul 11, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Teri Ann Martin, FNP

Title

Owner

Phone

(518) 852-5847

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1405036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405036800000",
    "number": "1245647189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 NORTH RIDGE EXTENSION",
            "address_2": "PO BOX 794",
            "city": "WINDHAM",
            "state": "NY",
            "postal_code": "124960794",
            "telephone_number": "518-852-5847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 NORTH RIDGE EXTENSION",
            "city": "WINDHAM",
            "state": "NY",
            "postal_code": "124960794",
            "telephone_number": "518-852-5847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERI MARTIN FAMILY NURSE PRACTITIONER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-11",
        "last_updated": "2014-07-11",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "TERI",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "518-852-5847",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NY",
            "license": "330978",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02093850",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Michael Gonzalez
• Robert Otten Jr., DC
• William Thomas Quackenbush III, RPH
• Rumi Sarkar
• SG Lisenced Behavior Analyst PC
• Town of Windham
• Ilse Berenice Turkmani
• Windham Ashland Jewett CSD
• Windham Pharma Inc (Windham Pharmacy)
• Windham Pharmacy of Greene County Inc (Windham Pharmacy)

• Primary Care Clinic/Center in Windham, NY
• Providers in Windham, NY by specialty
• Primary Care Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2014; 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.