Healthcare Provider Details

I. General information

NPI: 1396781506
Provider Name (Legal Business Name): MARTIN URAM M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 07/14/2021
Certification Date: 07/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 SYCAMORE AVE
LITTLE SILVER NJ
07739-1208
US

IV. Provider business mailing address

39 SYCAMORE AVE
LITTLE SILVER NJ
07739-1208
US

V. Phone/Fax

Practice location:
  • Phone: 732-530-7730
  • Fax: 732-530-3837
Mailing address:
  • Phone: 732-530-7730
  • Fax: 732-530-3837

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number25MA04067900
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number25MA04067900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: