Provider Demographics
NPI:1740212315
Name:ARKIN, MARTIN D (OD)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:D
Last Name:ARKIN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 EAST AVE
Mailing Address - Street 2:SUITE 3C
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-5721
Mailing Address - Country:US
Mailing Address - Phone:203-866-3280
Mailing Address - Fax:203-866-1124
Practice Address - Street 1:148 EAST AVE
Practice Address - Street 2:SUITE 3C
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-5721
Practice Address - Country:US
Practice Address - Phone:203-866-3280
Practice Address - Fax:203-866-1124
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT796152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTP386638Medicare UPIN
CT20930Medicare UPIN
CTT22353Medicare ID - Type Unspecified
CT090000796CT01Medicare UPIN
CT796000Medicare UPIN