Provider Demographics
NPI:1588557359
Name:MENDEZ MARTHALLER, MARISA ELIS
Entity type:Individual
Prefix:
First Name:MARISA
Middle Name:ELIS
Last Name:MENDEZ MARTHALLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 KINGSTON AVENUE
Mailing Address - Street 2:APT #2
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11213
Mailing Address - Country:US
Mailing Address - Phone:718-510-3444
Mailing Address - Fax:
Practice Address - Street 1:133 KINGSTON AVENUE
Practice Address - Street 2:APT #2
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213
Practice Address - Country:US
Practice Address - Phone:718-510-3444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-31
Last Update Date:2025-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula