Provider Demographics
NPI:1104261361
Name:DESBIENS, MARTHA TEPAS (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:TEPAS
Last Name:DESBIENS
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:DR
Other - First Name:MARTHA
Other - Middle Name:JANE
Other - Last Name:TEPAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:33 GERMANTOWN RD
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-5038
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:33 GERMANTOWN RD
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-5038
Practice Address - Country:US
Practice Address - Phone:203-739-8310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-01
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH19347207RI0200X, 207R00000X
390200000X
CT63914207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine