Martine, Tracy L

Martine, Tracy L is an individual health care provider with primary practice located at 1138 Broadway St , Elmira NY 14904-2502. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Martine, Tracy L can be contacted via phone (607) 734-7982.

Contact Information

Primary practice address
1138 Broadway St Elmira NY 14904-2502
Phone: (607) 734-7982
Fax: (607) 734-1953
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 343830 New York

Profile Details

NPI number 1770510778
LBN Legal business name Martine, Tracy L
Credentials CRNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 26th, 2006
Last updated Nov 25th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770510778 NPPES
Pennsylvania MEDICAID 102951190
Pennsylvania MEDICAID 05672046

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