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Individual

GLORIA G MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
WOMANS HEALTH

Contact information

Practice address
28 N 7TH ST, STROUDSBURG, PA 18360-2110
(610) 481-0481
(610) 481-0486
Mailing address
6900 HAMILTON BLVD, TREXLERTOWN, PA 18087-9100
(610) 481-0481
(610) 481-0486

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
159042
MA
363LW0102X
Women's Health Nurse Practitioner
159042
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1300709
CMSP-GROUP
MA
05
1300709
MA
01
58497
CMSP
MA
01
Y10141
BCBS-GROUP
MA
Enumeration date
08/09/2006
Last updated
12/15/2011
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