Provider Demographics
NPI:1376862615
Name:JENSON, MARTHA KAY (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:KAY
Last Name:JENSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:201 LAFAYETTE AVE
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-4707
Mailing Address - Country:US
Mailing Address - Phone:845-368-7400
Mailing Address - Fax:845-357-6644
Practice Address - Street 1:201 LAFAYETTE AVE
Practice Address - Street 2:
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-4707
Practice Address - Country:US
Practice Address - Phone:845-368-7400
Practice Address - Fax:845-357-6644
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-26
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY224262-1207Q00000X
PAMD057982L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine