MARTIN MARTINICKY NPI 1417630302

NPI Information

  • NPI: 1417630302
  • Provider Name: MARTIN MARTINICKY
  • Classification: Nurse Practitioner - 363LA2100X
  • Specialization: Acute Care
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 61 JERICHO TPKE
    JERICHO, NY
    ZIP 11753
  • Phone: (516) 544-8899

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NPI Details

Martin Martinicky is an acute care nurse practitioner in Jericho, NY. Martin Martinicky NPI is 1417630302. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

61 JERICHO TPKE
JERICHO, NY
ZIP 11753-051
Phone: (516) 544-8899
Fax: (516) 362-3939

The NPI 1417630302 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/8/2023 and was last updated on 8/8/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LA2100XNurse PractitionerAcute Care432741NEW YORKYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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