Provider Demographics
NPI:1326073909
Name:ELBIN, MARTIN JOHN (ACA, BC-HIS, LHAS)
Entity Type:Individual
Prefix:MR
First Name:MARTIN
Middle Name:JOHN
Last Name:ELBIN
Suffix:
Gender:M
Credentials:ACA, BC-HIS, LHAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1531 GARFIELD AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26101-3244
Mailing Address - Country:US
Mailing Address - Phone:304-893-9484
Mailing Address - Fax:304-893-9485
Practice Address - Street 1:1531 GARFIELD AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-3244
Practice Address - Country:US
Practice Address - Phone:304-893-9484
Practice Address - Fax:304-893-9485
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS0001872237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL610008200Medicaid