Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Martin Martinicky

Individual provider Acute Care Nurse Practitioner · NPI 1417630302

Martin Martinicky is a Nurse Practitioner in Jericho, New York. Qualified in 2023, 3 years ago. Licensed in New York.

Years since qualifying
3
Licensed in
NY
In the registry since
2023

Practice location Address checks out

61 Jericho Tpke
Jericho, NY 11753-1051
Phone: (516) 544-8899
Fax: (516) 362-3939
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 432741 (NY)

Record details

NPI number1417630302
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 8, 2023
Last updated in NPPESAugust 8, 2023
Certification dateJune 2, 2021
Mailing address9972 66th Rd Apt 7d, Rego Park, NY 11374-4443

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Not indicated