Provider Demographics
NPI:1114194941
Name:GEORGE J. MARTINO, MD, PA
Entity Type:Organization
Organization Name:GEORGE J. MARTINO, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:J
Authorized Official - Last Name:MARTINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-447-4500
Mailing Address - Street 1:541 CEDAR HILL AVE
Mailing Address - Street 2:
Mailing Address - City:WYCKOFF
Mailing Address - State:NJ
Mailing Address - Zip Code:07481-2150
Mailing Address - Country:US
Mailing Address - Phone:201-447-4500
Mailing Address - Fax:201-447-3699
Practice Address - Street 1:541 CEDAR HILL AVE
Practice Address - Street 2:
Practice Address - City:WYCKOFF
Practice Address - State:NJ
Practice Address - Zip Code:07481-2150
Practice Address - Country:US
Practice Address - Phone:201-447-4500
Practice Address - Fax:201-447-3699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02240000282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital