Provider Demographics
NPI:1023195401
Name:ROTHSCHILD, MARTIN (MD)
Entity Type:Individual
Prefix:MR
First Name:MARTIN
Middle Name:
Last Name:ROTHSCHILD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:885 PARK AVE OFC 1A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-0383
Mailing Address - Country:US
Mailing Address - Phone:212-737-6993
Mailing Address - Fax:212-794-7295
Practice Address - Street 1:885 PARK AVE OFC 1A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-0383
Practice Address - Country:US
Practice Address - Phone:212-737-6993
Practice Address - Fax:212-794-7295
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNYS121050207R00000X
NY121050207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0003218OtherGHI
03A531Medicare ID - Type Unspecified
A60013Medicare UPIN