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General NPI Number Information
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NPI Number | 1164485025
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Entity Type | Individual
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Provider Name | MARTIN MAN D.M.D,
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Gender | Male
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Dates
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Enumeration Date | 04/10/2006
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Last Update Date | 03/16/2021
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Provider Practice Location Address
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Address Line | 185 PARK ROW SUITE 6
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City | NEW YORK
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State | NY
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Zip | 10038-5000
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Country | US
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Telephone | 212-962-1305
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Fax | 212-964-3114
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Provider Business Mailing Address
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Address Line | 185 PARK ROW SUITE 6
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City | NEW YORK
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State | NY
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Zip | 10038-5000
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Country | US
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Telephone | 212-962-1305
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Fax | 347-983-7240
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 039608
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License Number State | NY
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