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NPI Code Detail

MEDICARE: MARTA J KROO MD

MEDICARE: MARTA J KROO MD
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
1207Q00000XFamily Medicine Physician034064CT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1508800806
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARTA J KROO MD
Provider Business Mailing Address
First Line : 28 CRESCENT ST
Second Line :
City : MIDDLETOWN
State : CT
Zip : 06457-3654
Country : US
Telephone Number : 860-358-4819
Fax Number : 860-358-4809
Provider Business Practice Location Address
First Line : 136 BERLIN RD
Second Line :
City : CROMWELL
State : CT
Zip : 06416-2627
Country : US
Telephone Number : 860-632-5570
Fax Number : 860-635-0097
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2006
Last Update Date : 04/22/2008

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