Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | 0101257763 | VA |
Y | 207L00000X | Anesthesiologist | 272924 | NY |
N | 207L00000X | Anesthesiologist | 9544203 | NY |
NPI | 1013232230 |
---|---|
Provider Name | Dr. Maisie Irene Martinick |
First Address | Lewiston, NY 14092 |
Second Address | Richmond, VA 23298-0257 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2010 |
Last Update Date | 18/03/2020 |