Provider Demographics
NPI:1558719740
Name:HERGER, MARTA LEA (MD, JD)
Entity Type:Individual
Prefix:DR
First Name:MARTA
Middle Name:LEA
Last Name:HERGER
Suffix:
Gender:F
Credentials:MD, JD
Other - Prefix:DR
Other - First Name:MARTA
Other - Middle Name:LEA
Other - Last Name:HOES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, JD
Mailing Address - Street 1:184 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06519-1625
Mailing Address - Country:US
Mailing Address - Phone:203-688-9704
Mailing Address - Fax:
Practice Address - Street 1:184 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06519-1625
Practice Address - Country:US
Practice Address - Phone:203-688-9704
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-27
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CT686892084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program