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General NPI Number Information
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NPI Number | 1346159811
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Entity Type | Individual
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Provider Name | ANTONIO MARTINEZ PA-C
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Gender | Male
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Dates
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Enumeration Date | 09/02/2026
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Last Update Date | 09/02/2026
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Provider Practice Location Address
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Address Line | 21 WOODLAND ST
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City | HARTFORD
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State | CT
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Zip | 06105-4318
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Country | US
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Telephone | 860-228-9300
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Fax | 860-228-4703
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Provider Business Mailing Address
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Address Line | 63 WHITMORE ST APT 1W
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City | HARTFORD
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State | CT
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Zip | 06114-1388
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Country | US
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Telephone | 860-228-9300
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Fax | 860-228-4703
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | CT7777
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License Number State | CT
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