Healthcare Provider Details

I. General information

NPI: 1528026770
Provider Name (Legal Business Name): MARTIN JOEL HECHT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 09/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

156 HEWES ST
BROOKLYN NY
11211-8901
US

IV. Provider business mailing address

156 HEWES ST
BROOKLYN NY
11211-8901
US

V. Phone/Fax

Practice location:
  • Phone: 718-797-3677
  • Fax: 718-218-7576
Mailing address:
  • Phone: 718-797-3677
  • Fax: 718-218-7576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number145907
License Number StateNY

VIII. Authorized Official

Name: MARTIN JOEL HECHT
Title or Position: SOLE PROPRIETER
Credential: MD
Phone: 718-797-9677