Provider Demographics
NPI:1861415051
Name:CONNELL, MARTHA GAY (DDS)
Entity type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:GAY
Last Name:CONNELL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:MARTHA
Other - Middle Name:CONNELL
Other - Last Name:BINDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:145 CENTRAL PARK W
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-2004
Mailing Address - Country:US
Mailing Address - Phone:212-787-4966
Mailing Address - Fax:212-787-6211
Practice Address - Street 1:145 CENTRAL PARK W
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-2004
Practice Address - Country:US
Practice Address - Phone:212-787-4966
Practice Address - Fax:212-787-6211
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY327031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice