Martin, Amy G

Martin, Amy G is an individual health care provider with primary practice located at 345 Montauk Ave , New London CT 06320-4738. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Women's Health, which is considered as her primary health care specialty. Martin, Amy G can be contacted via phone (860) 444-6868.

Contact Information

Primary practice address
345 Montauk Ave New London CT 06320-4738
Phone: (860) 444-6868
Fax: (860) 437-0650
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Women's Health 363LW0102X 001886 Connecticut

Profile Details

NPI number 1447244504
LBN Legal business name Martin, Amy G
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 6th, 2005
Last updated Sep 3rd, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447244504 NPPES
Connecticut Other 101886 CONNECTICARE
Connecticut MEDICAID 004197027 CONNECTICARE
Connecticut Other 2V5539 CONNECTICARE

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