Basic Information
Provider Information
NPI: 1932587458
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MARTINEZ PITRE
FirstName: PEDRO
MiddleName: J
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
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OtherCredential:  
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Mailing Information
Address1: PO BOX 9277
Address2: COTTO STATION
City: ARECIBO
State: PR
PostalCode: 006139277
CountryCode: US
TelephoneNumber: 7872201643
FaxNumber:  
Practice Location
Address1: 374 STOCKHOLM ST
Address2:  
City: BROOKLYN
State: NY
PostalCode: 112374006
CountryCode: US
TelephoneNumber: 7189637272
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/16/2015
LastUpdateDate: 05/30/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X298273NYY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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