Individual
MARCIA WAITZMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
680 CENTRE ST, BROCKTON, MA 02302-3308
(508) 941-7299
Mailing address
22 HIGH POINT LN, WEST HARTFORD, CT 06107-1135
(860) 604-6998
(860) 232-6886
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
031416
CT
207V00000X
Obstetrics & Gynecology Physician
145062-1
NY
207V00000X
Obstetrics & Gynecology Physician
242462
MA
207V00000X
Obstetrics & Gynecology Physician
25MA09212800
NJ
207V00000X
Obstetrics & Gynecology Physician
D0033764
MD
207V00000X
Obstetrics & Gynecology Physician
G49767
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1314161
—
CT
Enumeration date
07/01/2005
Last updated
03/05/2019
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