Provider Demographics
NPI:1780809541
Name:MARTZ, GABRIEL U (MD)
Entity type:Individual
Prefix:
First Name:GABRIEL
Middle Name:U
Last Name:MARTZ
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Gender:M
Credentials:MD
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Mailing Address - Street 1:80 SEYMOUR ST
Mailing Address - Street 2:JEFFERSON BUILDING, SUITE 607
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06102
Mailing Address - Country:US
Mailing Address - Phone:860-972-0726
Mailing Address - Fax:860-545-1976
Practice Address - Street 1:85 SEYMOUR ST STE 815
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-5527
Practice Address - Country:US
Practice Address - Phone:860-972-3600
Practice Address - Fax:860-545-5003
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2023-02-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY472662084N0400X, 2084N0600X
CT571522084N0400X, 2084N0600X, 2084E0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084E0001XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyEpilepsy
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1780809541Medicaid