Individual
DR. ANDREW LEE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
9 CHARLTON ST, PRINCETON, NJ 08540
(609) 454-3214
(609) 250-7108
Mailing address
9 CHARLTON ST, PRINCETON, NJ 08540-5231
(609) 454-3214
(609) 250-7108
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
03841
MD
103TC0700X
Clinical Psychologist
Primary
6742
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
405146700
—
MD
01
—
64161101
BCBS
MD
01
—
77260044
BCBS
DC
Enumeration date
12/01/2006
Last updated
04/02/2019
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