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General NPI Number Information
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NPI Number | 1851242648
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Entity Type | Individual
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Provider Name | MARTIN JOSE
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Gender | Male
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Dates
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Enumeration Date | 02/06/2026
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Last Update Date | 02/06/2026
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Provider Practice Location Address
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Address Line | 7003 MAIN ST
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City | STRATFORD
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State | CT
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Zip | 06614-1393
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Country | US
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Telephone | 475-225-9895
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Fax |
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Provider Business Mailing Address
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Address Line | 95 KING ST
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City | BRIDGEPORT
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State | CT
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Zip | 06605-2920
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Country | US
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Telephone | 475-225-9895
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Fax |
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 002028
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License Number State | CT
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