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NPI Code Detail

MEDICARE: LAURA MARTIN

MEDICARE: LAURA MARTIN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367A00000XAdvanced Practice Midwife25ME00003001NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
125ME00003000OTHERNJCNM LICENSE
225ME00003001OTHERNJCNM W/PRESCRIPTIVE AUTHOR

General Provider Information

NPI Number : 1194736900
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA MARTIN
Provider Business Mailing Address
First Line : 1700 MYRTLE AVE
Second Line :
City : PLAINFIELD
State : NJ
Zip : 07063-1000
Country : US
Telephone Number : 908-753-6401
Fax Number :
Provider Business Practice Location Address
First Line : 1700 MYRTLE AVE
Second Line :
City : PLAINFIELD
State : NJ
Zip : 07063-1000
Country : US
Telephone Number : 908-753-6401
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2006
Last Update Date : 02/20/2013

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Directions to “ LAURA MARTIN ” Practice Location

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