Small, Martha Y
Small, Martha Y is an individual health care provider with primary practice located at 4699 Main St Suite 215, Bridgeport CT 06606-1830. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Small, Martha Y can be contacted via phone (203) 452-8322.Contact Information
Primary practice address
4699 Main St Suite 215
Bridgeport CT 06606-1830
Phone: (203) 452-8322
Fax: (203) 452-2296
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 028062 | Connecticut |
Profile Details
| NPI number | 1720195209 |
|---|---|
| LBN Legal business name | Small, Martha Y |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 23rd, 2006 |
| Last updated | Jul 8th, 2007 - about 19 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1720195209 | NPPES |
| Connecticut | MEDICAID | 001280627 |
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