Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | F402498 | NY |
NPI | 1003290362 |
---|---|
Provider Name | Melissa Martyn |
First Address | Yonkers, NY 10701-3713 |
Second Address | Yonkers, NY 10701-3713 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2015 |
Last Update Date | 31/10/2019 |