Basic Information
Provider Information
NPI: 1023772019
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MARTINEZ-BROWN
FirstName: BRENDA
MiddleName: D.
NamePrefix: MS.
NameSuffix:  
Credential: MSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 845 N BROADWAY
Address2:  
City: WHITE PLAINS
State: NY
PostalCode: 106032403
CountryCode: US
TelephoneNumber: 9147610600
FaxNumber: 9147615367
Practice Location
Address1: 135 LOCUST HILL AVE
Address2:  
City: YONKERS
State: NY
PostalCode: 107012917
CountryCode: US
TelephoneNumber: 9143768174
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/26/2021
LastUpdateDate: 10/26/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/26/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
104100000X  Y Behavioral Health & Social Service ProvidersSocial Worker 

No ID Information.


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