DR. ELLIOTT BURTON MARTIN JR. (NPI# 1073741617) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073741617 |
| Entity Type | Individual |
| Full Name | DR. ELLIOTT BURTON MARTIN JR. |
| Credential | M.D. |
| Practice Address |
94 Dover Rd West Hartford CT 06119-1214 |
| Practice Telephone | 6174296997 |
| Mailing Telephone | 6174296997 |
| Enumeration Date | 2009-06-22 |
| Last Update Date | 2009-06-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
94 DOVER RD |
| City | WEST HARTFORD |
| State | CT |
| Zip Code | 06119-1214 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063957389 | Hannah Aliberti | Behavioral Analyst | 792 Farmington Ave, West Hartford, CT 06119 | 2016-12-21 |
| 1255752945 | Ctuc01 | Clinic/Center | 1030 Boulevard, West Hartford, CT 06119 | 2013-12-23 |
| 1962757088 | Arman Samad-zadeh | Dentist | 836 Farmington Ave Ste 115, West Hartford, CT 06119 | 2012-07-15 |
| 1356606123 | East West Obgyn | Obstetrics & Gynecology | 836 Farmington Ave. S. 211, West Hartford, CT 06119 | 2012-07-09 |
| 1285901314 | Onyeijen Mgbejume | Pharmacist | 674 Famington Avenue, West Hartford, CT 06119 | 2011-11-17 |
| 1134403553 | Cornelia F Sharrow | Social Worker | 17 South Highland St, West Hartford, CT 06119 | 2011-10-04 |
| 1952613218 | Lauren B Kopyt | Pediatrics | 785 Farmington Avenue, West Hartford, CT 06119 | 2010-07-02 |
| 1043542657 | Leticia Jacquet | Physical Therapist | 1022 Boulevard, #274, West Hartford, CT 06119 | 2010-02-06 |
| 1003051467 | Emily Bevelaqua Pellegrino | Music Therapist | 72 Maplewood Ave, West Hartford, CT 06119 | 2008-12-12 |
| 1124233473 | Theresa M Johnson | Counselor | 361 Park Rd, 3rd Fl, West Hurtford, CT 06119 | 2007-05-11 |
| Find all providers in zip 06119 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902448988 | Christopher Mello | Student in an Organized Health Care Education/Training Program | 6 Squirrel Hill Ln, West Hartford, CT 06107-1035 | 2019-10-11 |
| 1972167500 | Hannah Johnson | Student in an Organized Health Care Education/Training Program | 137 Woodpond Rd, West Hartford, CT 06107-3540 | 2019-04-29 |
| 1235632498 | Leila Fussell | Student in an Organized Health Care Education/Training Program | 175 Garfield Rd, West Hartford, CT 06107 | 2018-03-14 |
| 1366899122 | Isra Yaghoubi | Student in an Organized Health Care Education/Training Program | 1 King Philip Dr Unit 211, West Hartford, CT 06117-2145 | 2016-05-20 |
| 1992047898 | Arturo Ricardo Montano | Student in an Organized Health Care Education/Training Program | 20 Outlook Ave, Apt 201, West Hartford, CT 06119-1448 | 2013-03-19 |
| 1073159257 | Michelle Bracha | Student in an Organized Health Care Education/Training Program | 101 South St, West Hartford, CT 06110-1967 | 2019-11-21 |
| 1790336246 | Lady Fernanda Carphio | Student in an Organized Health Care Education/Training Program | 101 South St, West Hartford, CT 06110-1967 | 2019-09-26 |
| 1912488867 | Rene F Jones | Student in an Organized Health Care Education/Training Program | 101 South St, West Hartford, CT 06110-1967 | 2018-08-28 |
| 1104276609 | Heather Mcsherry | Student in an Organized Health Care Education/Training Program | 101 South St Fl 2, West Hartford, CT 06110-1967 | 2016-06-15 |
| 1518392778 | Shayna Rose Ull | Student in an Organized Health Care Education/Training Program | 333 Bloomfield Ave, West Hartford, CT 06117-1500 | 2013-09-06 |
| Find all providers in WEST HARTFORD | ||||
| City | WEST HARTFORD |
| Zip Code | 06119 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.