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NPI Code Detail

MEDICARE: MARTIN R PRINCE MD, PHD, FACR

MEDICARE: MARTIN R PRINCE MD, PHD, FACR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician213343NY

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3W35021OTHERNYMEDICARE GROUP #

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1356373096
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARTIN R PRINCE MD, PHD, FACR
Provider Business Mailing Address
First Line : 2649 STRANG BLVD STE 304
Second Line :
City : YORKTOWN HEIGHTS
State : NY
Zip : 10598-2938
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 506 6TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11215-3609
Country : US
Telephone Number : 718-780-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2006
Last Update Date : 05/28/2026

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