Provider Demographics
NPI:1780142265
Name:ARIOLA, MARTIN RAYMOND (MA, CAS)
Entity type:Individual
Prefix:MR
First Name:MARTIN
Middle Name:RAYMOND
Last Name:ARIOLA
Suffix:
Gender:M
Credentials:MA, CAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 GRAND ST
Mailing Address - Street 2:
Mailing Address - City:THOMASTON
Mailing Address - State:CT
Mailing Address - Zip Code:06787-1417
Mailing Address - Country:US
Mailing Address - Phone:860-733-2345
Mailing Address - Fax:
Practice Address - Street 1:175 MAIN ST S
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:CT
Practice Address - Zip Code:06798-3448
Practice Address - Country:US
Practice Address - Phone:860-733-2345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-04
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program