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1255844197
PHILEASE J MARTIN
STAMFORD, CT
NPI
1255844197
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: NY 021588-1)
Enumeration Date
2017-11-14
Last Update Date
2017-11-14
Business Address
PHILEASE J MARTIN
2001 W MAIN ST
STAMFORD, CT 06902-4501
Phone number: 203-658-8291
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Mailing Address
PHILEASE J MARTIN
21715 JAMAICA AVE APT 2B
QUEENS VILLAGE, NY 11428-2122
Phone number: 773-910-2518
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