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NPI Code Detail

MEDICARE: DR. DAMIAN JOSEPH MARTINO M.D.

MEDICARE: DR. DAMIAN JOSEPH MARTINO M.D.
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
1208VP0000XPain Medicine Physician246439NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1246439OTHERNYNY LICENSE

General Provider Information

NPI Number : 1659537041
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAMIAN JOSEPH MARTINO M.D.
Provider Business Mailing Address
First Line : 3601 31ST AVE STE 1B
Second Line :
City : ASTORIA
State : NY
Zip : 11106-1051
Country : US
Telephone Number : 917-485-1905
Fax Number : 917-456-0437
Provider Business Practice Location Address
First Line : 3272 STEINWAY ST STE B01
Second Line :
City : ASTORIA
State : NY
Zip : 11103-4183
Country : US
Telephone Number : 917-485-1905
Fax Number : 917-456-0437
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2008
Last Update Date : 03/22/2023

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