Organization
MARTHA SEVERINO MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARTHA Z. SEVERINO (OWNER)
(203) 240-4143
Entity
Organization
Contact information
Practice address
67 SAND PIT RD, SUITE #202, DANBURY, CT 06810-4032
(203) 778-5500
Mailing address
36 TAMARACK AVE, SUITE #322, DANBURY, CT 06811-4822
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
040024
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DE7965
MEDICARE RAILROAD
CT
Enumeration date
03/14/2008
Last updated
05/06/2008
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