Provider Demographics
NPI:1396739231
Name:MARTIN, LUZ M (MD)
Entity type:Individual
Prefix:DR
First Name:LUZ
Middle Name:M
Last Name:MARTIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LUZ
Other - Middle Name:M
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:299 CAREW ST
Mailing Address - Street 2:SUITE NUMBER 300
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01104-2301
Mailing Address - Country:US
Mailing Address - Phone:413-739-7680
Mailing Address - Fax:413-739-6599
Practice Address - Street 1:299 CAREW ST
Practice Address - Street 2:SUITE NUMBER 300
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-2301
Practice Address - Country:US
Practice Address - Phone:413-739-7680
Practice Address - Fax:413-739-6599
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-07
Last Update Date:2013-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA774422084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3111105Medicaid
MA3111105Medicaid
MAF61722Medicare UPIN