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NPI Code Detail

MEDICARE: DR. ALFREDO R MARTIJA M.D.

MEDICARE: DR. ALFREDO R MARTIJA M.D.
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
12084P0800XPsychiatry Physician205294MA

General Provider Information

NPI Number : 1760440796
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALFREDO R MARTIJA M.D.
Provider Business Mailing Address
First Line : 8 MUSEUM WAY
Second Line : UNIT 2302
City : CAMBRIDGE
State : MA
Zip : 02141-1887
Country : US
Telephone Number : 857-891-1128
Fax Number : 844-365-7165
Provider Business Practice Location Address
First Line : 2100 DORCHESTER AVE
Second Line :
City : BOSTON
State : MA
Zip : 02124-5615
Country : US
Telephone Number : 857-891-1128
Fax Number : 844-365-7165
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2006
Last Update Date : 03/15/2016

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