Provider Demographics
NPI:1073940284
Name:ANITA KAY MARTIN, M.D. P.C.
Entity Type:Organization
Organization Name:ANITA KAY MARTIN, M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANITA KAY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-217-9207
Mailing Address - Street 1:20507 HILLSIDE AVE STE 28
Mailing Address - Street 2:
Mailing Address - City:HOLLIS
Mailing Address - State:NY
Mailing Address - Zip Code:11423-2220
Mailing Address - Country:US
Mailing Address - Phone:718-217-9207
Mailing Address - Fax:718-217-9334
Practice Address - Street 1:20507 HILLSIDE AVE STE 28
Practice Address - Street 2:
Practice Address - City:HOLLIS
Practice Address - State:NY
Practice Address - Zip Code:11423-2220
Practice Address - Country:US
Practice Address - Phone:718-217-9207
Practice Address - Fax:718-217-9334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-02
Last Update Date:2013-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY182057207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty