Healthcare Provider Details

I. General information

NPI: 1609908532
Provider Name (Legal Business Name): TAMAR JEAN MARTIN PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

53 TALLMADGE PL
MECHANICVILLE NY
12118-2320
US

IV. Provider business mailing address

53 TALLMADGE PL
MECHANICVILLE NY
12118-2320
US

V. Phone/Fax

Practice location:
  • Phone: 518-664-0739
  • Fax:
Mailing address:
  • Phone: 518-664-0739
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number047898
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number24929
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number047898
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number24929
License Number StateMA
# 5
Primary TaxonomyN
Taxonomy Code1835N1003X
TaxonomyNutrition Support Pharmacist
License Number047898
License Number StateNY
# 6
Primary TaxonomyN
Taxonomy Code1835N1003X
TaxonomyNutrition Support Pharmacist
License Number24929
License Number StateMA
# 7
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number047898
License Number StateNY
# 8
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number24929
License Number StateMA
# 9
Primary TaxonomyN
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License Number047898
License Number StateNY
# 10
Primary TaxonomyN
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License Number24929
License Number StateMA
# 11
Primary TaxonomyN
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number047898
License Number StateNY
# 12
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number24929
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: