Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | 038302 | CT |
N | 207RA0401X | Internist - Addiction Medicine | 221034-1 | NY |
NPI | 1891889010 |
---|---|
Provider Name | Dr. Bridget Ann Martell |
First Address | New Haven, CT 06520 |
Second Address | New Haven, CT 06520 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 11/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H10689 | (02) | NY |