Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 048002 | CT |
NPI | 1033341011 |
---|---|
Provider Name | Maria A Martin |
First Address | Norwalk, CT 06851-1080 |
Second Address | Norwalk, CT 06851-1080 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2009 |
Last Update Date | 16/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
004187466 | (05) | CT |