Provider Demographics
NPI:1235485723
Name:BECKER, MARTHA (RN)
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:
Last Name:BECKER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 HAZEL ST
Mailing Address - Street 2:
Mailing Address - City:ONEONTA
Mailing Address - State:NY
Mailing Address - Zip Code:13820-1307
Mailing Address - Country:US
Mailing Address - Phone:607-432-4917
Mailing Address - Fax:
Practice Address - Street 1:31 CENTER ST
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:NY
Practice Address - Zip Code:13820-1428
Practice Address - Country:US
Practice Address - Phone:607-433-8200
Practice Address - Fax:607-433-3642
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-02
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY374621-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool