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Individual

MRS. AMY G MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
345 MONTAUK AVE, NEW LONDON, CT 06320-4738
(860) 444-6868
(860) 437-0650
Mailing address
345 MONTAUK AVE, NEW LONDON, CT 06320-4738
(860) 444-6868
(860) 437-0650

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
001886
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004197027
CT
01
101886
CONNECTICARE
CT
01
2V5539
HEALTH NET
CT
Enumeration date
09/06/2005
Last updated
09/03/2014
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