Individual
MEGAN BLAKE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
140 PROSPECT AVE STE 30, HACKENSACK, NJ 07601-2255
(201) 488-0066
Mailing address
140 PROSPECT AVE STE 30, HACKENSACK, NJ 07601-2255
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
25MA09340400
NJ
Other
Enumeration date
04/08/2009
Last updated
08/26/2013
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