Healthcare Provider Details

I. General information

NPI: 1386646693
Provider Name (Legal Business Name): MARTIN H BROWNSTEIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 N PLANDOME RD
PORT WASHINGTON NY
11050-3443
US

IV. Provider business mailing address

2 N PLANDOME RD
PORT WASHINGTON NY
11050-3443
US

V. Phone/Fax

Practice location:
  • Phone: 516-944-3882
  • Fax: 516-883-2936
Mailing address:
  • Phone: 516-944-3882
  • Fax: 516-883-2936

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License Number087998
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: