Provider Demographics
NPI:1679317382
Name:BRAU MARTINEZ, REBECA
Entity type:Individual
Prefix:
First Name:REBECA
Middle Name:
Last Name:BRAU MARTINEZ
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 1:50 FULTON ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-1800
Mailing Address - Country:US
Mailing Address - Phone:973-270-4422
Mailing Address - Fax:
Practice Address - Street 1:50 FULTON ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-1800
Practice Address - Country:US
Practice Address - Phone:973-270-4422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-19
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist