Individual
MARTHA PUTNAM
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5875 S TRANSIT RD, LOCKPORT, NY 14094-6340
(716) 433-3053
(716) 433-3118
Mailing address
5875 S TRANSIT RD, LOCKPORT, NY 14094-6340
(716) 433-3053
(716) 433-3118
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F4203051
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010301401
UNIVERA
NY
01
—
000560461003
BCBS
NY
05
—
01735648
—
NY
01
—
0709051
IND HEALTH
NY
Enumeration date
02/08/2006
Last updated
07/08/2007
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