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General NPI Number Information
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NPI Number | 1245211416
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Entity Type | Individual
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Provider Name | MAURICE JOSEPH MARTIN MD
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Gender | Male
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Dates
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Enumeration Date | 11/07/2005
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 1824 MADISON AVE
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City | NEW YORK
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State | NY
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Zip | 10035-3832
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Country | US
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Telephone | 212-423-4500
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Fax |
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Provider Business Mailing Address
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Address Line | 245 E 21ST ST APT 14A
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City | NEW YORK
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State | NY
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Zip | 10010-6412
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Country | US
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Telephone | 617-838-5587
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 286047
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License Number State | NY
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