MEDICARE: DONALD MARTIN PT

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
1	225100000X	Physical Therapist	40QA01153600	NJ
2	174400000X	Specialist	40QA01153600	NJ

General Provider Information

NPI Number	:	1538357744
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONALD MARTIN PT

Provider Business Mailing Address
First Line	:	870 PALISADE AVE STE 203
Second Line	:
City	:	TEANECK
State	:	NJ
Zip	:	07666-3445
Country	:	US
Telephone Number	:	201-399-0100
Fax Number	:	201-399-0101

Provider Business Practice Location Address
First Line	:	870 PALISADE AVE STE 203
Second Line	:
City	:	TEANECK
State	:	NJ
Zip	:	07666-3445
Country	:	US
Telephone Number	:	201-399-0100
Fax Number	:	201-399-0101

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2007
Last Update Date	:	03/10/2025

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Directions to “ DONALD MARTIN PT” Practice Location

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