Individual
DR. MARTHA MAIETTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
14 VINE ST, NEW BRITAIN, CT 06052-1431
(860) 229-1905
(860) 826-7292
Mailing address
30 VINE ST, NEW BRITAIN, CT 06052-1431
(860) 229-1905
(860) 826-7292
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
002123
CT
152W00000X
Optometrist
Primary
02123
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004112306
—
CT
Enumeration date
09/22/2006
Last updated
07/21/2016
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