Martinez Mckeithan, HS1
Technician, Other in New Haven, CT. Individual provider (NPI-1).
NPI number1275564700
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1275564700
- Entity type
- Individual (NPI-1)
- Name
- Mr. Martinez Mckeithan
- Credential
- HS1
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 5, 2006
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 247200000X | Technician, Other | – | – | Yes |
Practice location
120 Woodward AveCommander Uscg Sector Long Island Sound
New Haven, CT 06512-3628
Phone 203-468-4593 · Fax 203-468-4483
Mailing address
120 Woodward AveCommander Uscg Sector Long Island Sound
New Haven, CT 06512
Phone 203-468-4593 · Fax 203-468-4483
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Other Technician, Other providers in New Haven, CT
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