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General NPI Number Information
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NPI Number | 1588761480
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Entity Type | Organization
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Legal Business Name | MARTHA D. PILCHMAN, MD PLLC
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 02/14/2011
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Provider Practice Location Address
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Address Line | 85 W MAIN ST STE 101
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City | BAY SHORE
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State | NY
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Zip | 11706-8345
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Country | US
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Telephone | 631-666-1400
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Fax | 631-666-5781
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Provider Business Mailing Address
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Address Line | 85 W MAIN ST STE 101
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City | BAY SHORE
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State | NY
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Zip | 11706-8345
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Country | US
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Telephone | 631-666-1400
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Fax | 631-666-5781
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. MARTHA DELGADILLO PILCHMAN
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Credential | M.D.
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Telephone | 631-666-9083
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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 | 154767
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License Number State | NY
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