Provider Demographics
NPI:1407840655
Name:MARTINI, PATRICIA P (APRN)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:P
Last Name:MARTINI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 MONTAUK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:CT
Mailing Address - Zip Code:06320-4738
Mailing Address - Country:US
Mailing Address - Phone:860-444-6868
Mailing Address - Fax:860-437-0650
Practice Address - Street 1:345 MONTAUK AVE
Practice Address - Street 2:
Practice Address - City:NEW LONDON
Practice Address - State:CT
Practice Address - Zip Code:06320-4738
Practice Address - Country:US
Practice Address - Phone:860-444-6868
Practice Address - Fax:860-437-0650
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001146207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT0114606640OtherCONNECTICARE
CT2V6465OtherHEALTH NET
CT0114606640OtherCONNECTICARE