Provider Demographics
NPI:1164596995
Name:TOTIN, MARTHA J (PSY D)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:J
Last Name:TOTIN
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4985 HARLEM ROAD
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226
Mailing Address - Country:US
Mailing Address - Phone:716-839-0500
Mailing Address - Fax:716-839-0523
Practice Address - Street 1:4985 HARLEM ROAD
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226
Practice Address - Country:US
Practice Address - Phone:716-839-0500
Practice Address - Fax:716-839-0523
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015805103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical