Provider Demographics
NPI:1932392511
Name:MARTIN, CATHY (CA, LAC,AHG, PC)
Entity Type:Individual
Prefix:MS
First Name:CATHY
Middle Name:
Last Name:MARTIN
Suffix:
Gender:F
Credentials:CA, LAC,AHG, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:971 CRYSTAL LAKE TER
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07417-1312
Mailing Address - Country:US
Mailing Address - Phone:201-337-8725
Mailing Address - Fax:
Practice Address - Street 1:971 CRYSTAL LAKE TER
Practice Address - Street 2:
Practice Address - City:FRANKLIN LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07417-1312
Practice Address - Country:US
Practice Address - Phone:201-337-8725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-27
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJ25MZ00006100171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist