Provider Demographics
NPI:1740263300
Name:MARTZ, PATRICIA A (MD, FACS)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:A
Last Name:MARTZ
Suffix:
Gender:F
Credentials:MD, FACS
Other - Prefix:DR
Other - First Name:PATRICIA
Other - Middle Name:A
Other - Last Name:MARTZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 593
Mailing Address - Street 2:
Mailing Address - City:CAPE MAY COURT HOUSE
Mailing Address - State:NJ
Mailing Address - Zip Code:08210-0593
Mailing Address - Country:US
Mailing Address - Phone:609-463-2755
Mailing Address - Fax:609-463-2757
Practice Address - Street 1:217 N MAIN ST
Practice Address - Street 2:SUITE 104
Practice Address - City:CAPE MAY COURT HOUSE
Practice Address - State:NJ
Practice Address - Zip Code:08210-2165
Practice Address - Country:US
Practice Address - Phone:609-463-1488
Practice Address - Fax:609-463-4881
Is Sole Proprietor?:No
Enumeration Date:2005-11-28
Last Update Date:2015-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD059494L174400000X
NJ25MA09670700208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8285403Medicaid
PA001757688004Medicaid
NJ413899WXTMedicare PIN
PAG782242Medicare UPIN