Provider Demographics
NPI:1023043791
Name:MARTYN, MARINA ANNE RATHIKA (MD)
Entity Type:Individual
Prefix:
First Name:MARINA ANNE
Middle Name:RATHIKA
Last Name:MARTYN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 SENECA ST
Mailing Address - Street 2:
Mailing Address - City:ONEIDA
Mailing Address - State:NY
Mailing Address - Zip Code:13421-2668
Mailing Address - Country:US
Mailing Address - Phone:315-361-1623
Mailing Address - Fax:
Practice Address - Street 1:600 SENECA STREET
Practice Address - Street 2:ONEIDA MEDICAL ASSOCIATES PLLC
Practice Address - City:ONEIDA
Practice Address - State:NY
Practice Address - Zip Code:13421
Practice Address - Country:US
Practice Address - Phone:315-363-1346
Practice Address - Fax:315-363-9243
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207468207R00000X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01821627Medicaid
NYG52543Medicare UPIN
NYG52543Medicare UPIN