Provider Demographics
NPI:1932156890
Name:SZOKE, MARTA AGNES (MD)
Entity Type:Individual
Prefix:MRS
First Name:MARTA
Middle Name:AGNES
Last Name:SZOKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 COTTAGE ST
Mailing Address - Street 2:
Mailing Address - City:POTSDAM
Mailing Address - State:NY
Mailing Address - Zip Code:13676-1979
Mailing Address - Country:US
Mailing Address - Phone:315-265-0907
Mailing Address - Fax:315-268-1017
Practice Address - Street 1:25 COTTAGE ST
Practice Address - Street 2:
Practice Address - City:POTSDAM
Practice Address - State:NY
Practice Address - Zip Code:13676-1979
Practice Address - Country:US
Practice Address - Phone:315-265-0907
Practice Address - Fax:315-268-1017
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY186012208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01262380Medicaid
NY366604OtherMVP INSURANCE PROVIDER ID