Provider Demographics
NPI:1538157458
Name:KAFKA, MARTIN PAUL (MD)
Entity type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:PAUL
Last Name:KAFKA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 BEAUMONT AVE
Mailing Address - Street 2:
Mailing Address - City:NEWTONVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02460-2330
Mailing Address - Country:US
Mailing Address - Phone:617-964-1025
Mailing Address - Fax:
Practice Address - Street 1:22 MILL ST
Practice Address - Street 2:SUITE #306
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02476-4784
Practice Address - Country:US
Practice Address - Phone:781-643-0610
Practice Address - Fax:781-643-1609
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-13
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA564192084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3021041Medicaid
MAJO2422OtherBLUE CROSS BLUE SHIELD
MAJO2422-26Medicare UPIN
MAJO2422OtherBLUE CROSS BLUE SHIELD