Individual
DR. MARTHA Y SMALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4699 MAIN ST, SUITE 215, BRIDGEPORT, CT 06606-1830
(203) 452-8322
(203) 452-2296
Mailing address
15 CORPORATE DIVE, TRUMBULL, CT 06611
(203) 452-8322
(203) 452-2296
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
028062
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001280627
—
CT
Enumeration date
08/23/2006
Last updated
07/08/2007
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