Provider Demographics
NPI:1023865912
Name:MARTINEZ, JOSELYN (DACCHM, LAC)
Entity type:Individual
Prefix:DR
First Name:JOSELYN
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:X
Credentials:DACCHM, LAC
Other - Prefix:DR
Other - First Name:JOSS
Other - Middle Name:
Other - Last Name:MARTINEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DACCHM, LAC
Mailing Address - Street 1:109 N 12TH ST.
Mailing Address - Street 2:SUITE 704
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11249-1002
Mailing Address - Country:US
Mailing Address - Phone:786-399-3982
Mailing Address - Fax:
Practice Address - Street 1:109 N 12TH ST.
Practice Address - Street 2:SUITE 704
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11249-1002
Practice Address - Country:US
Practice Address - Phone:786-399-3982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-30
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19835171100000X
NY007484171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist