Provider Demographics
NPI:1891889010
Name:MARTELL, BRIDGET ANN (MD,MA)
Entity Type:Individual
Prefix:DR
First Name:BRIDGET
Middle Name:ANN
Last Name:MARTELL
Suffix:
Gender:F
Credentials:MD,MA
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Mailing Address - Street 1:PO BOX 208025
Mailing Address - Street 2:YALE UNIVERSITY SECTION OF GENERAL INTERNAL MEDICINE
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06520
Mailing Address - Country:US
Mailing Address - Phone:203-688-6532
Mailing Address - Fax:203-688-1198
Practice Address - Street 1:20 YORK ST.
Practice Address - Street 2:YALE UNIVERSITY SECTION OF GENERAL INTERNAL MEDICINE
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06520
Practice Address - Country:US
Practice Address - Phone:203-688-6532
Practice Address - Fax:203-688-1198
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2012-04-11
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Provider Licenses
StateLicense IDTaxonomies
CT038302207RA0401X
NY221034-1207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH10689Medicare UPIN