Healthcare Provider Details

I. General information

NPI: 1235824855
Provider Name (Legal Business Name): MARTIN NICOLAS MCINTOSH M.B.B.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2023
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

JACOBI MEDICAL CENTER, 1400 PELHAM PARKWAY SOUTH
BRONX NY
10461
US

IV. Provider business mailing address

JACOBI MEDICAL CENTER, 1400 PELHAM PARKWAY SOUTH
BRONX NY
10461
US

V. Phone/Fax

Practice location:
  • Phone: 718-918-5000
  • Fax:
Mailing address:
  • Phone: 718-918-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number3020109
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: