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General NPI Number Information
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NPI Number | 1194605014
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Entity Type | Individual
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Provider Name | JANELL MARTIN
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Gender | Female
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Dates
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Enumeration Date | 09/03/2025
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 87 CHURCH ST
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City | EAST HARTFORD
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State | CT
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Zip | 06108-3720
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Country | US
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Telephone | 860-291-9154
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Fax | 860-291-9728
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Provider Business Mailing Address
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Address Line | 7 JOYCE ST
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City | BLOOMFIELD
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State | CT
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Zip | 06002-3379
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Country | US
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Telephone | 860-291-9154
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Fax | 860-291-9728
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State | CT
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