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NPI Code Detail

MEDICARE: DR. KEVIN MARTIN M.D.

MEDICARE:  DR. KEVIN  MARTIN  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
12084P0804XChild & Adolescent Psychiatry Physician219540NY

Other Identifiers

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

General Provider Information

NPI Number : 1750488862
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KEVIN MARTIN M.D.
Provider Business Mailing Address
First Line : 21 HARVEST LN
Second Line :
City : GANSEVOORT
State : NY
Zip : 12831-2530
Country : US
Telephone Number : 518-584-0383
Fax Number :
Provider Business Practice Location Address
First Line : 30 CRESCENT AVE
Second Line :
City : SARATOGA SPRINGS
State : NY
Zip : 12866-5142
Country : US
Telephone Number : 518-584-3600
Fax Number : 518-584-3235
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2006
Last Update Date : 07/09/2007

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Directions to “ DR. KEVIN MARTIN M.D.” Practice Location

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