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Individual

MR. MARTINEZ MCKEITHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
HS1

Contact information

Practice address
120 WOODWARD AVE, COMMANDER USCG SECTOR LONG ISLAND SOUND, NEW HAVEN, CT 06512-3628
(203) 468-4593
(203) 468-4483
Mailing address
120 WOODWARD AVE, COMMANDER USCG SECTOR LONG ISLAND SOUND, NEW HAVEN, CT 06512
(203) 468-4593
(203) 468-4483

Taxonomy

Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary

Other

Enumeration date
07/05/2006
Last updated
07/08/2007
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