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General NPI Number Information
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NPI Number | 1699936195
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Entity Type | Organization
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Legal Business Name | KIDNEY DOCTORS, PLLC
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Dates
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Enumeration Date | 06/18/2008
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Last Update Date | 09/29/2008
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Provider Practice Location Address
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Address Line | 184 W MONTAUK HWY BLDG C
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City | HAMPTON BAYS
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State | NY
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Zip | 11946-2304
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Country | US
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Telephone | 631-594-2724
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Fax | 631-685-1453
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Provider Business Mailing Address
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Address Line | 184 W MONTAUK HWY BLDG C
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City | HAMPTON BAYS
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State | NY
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Zip | 11946-2304
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Country | US
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Telephone | 631-594-2724
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Fax | 631-685-1453
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CLAUDIO MARTINCIC
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Credential | DO
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Telephone | 631-594-2724
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 202633
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License Number State | NY
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