Provider Demographics
NPI:1205829736
Name:FOX, MARTIN J (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:J
Last Name:FOX
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:410 LAKEVILLE RD
Mailing Address - Street 2:STE 300
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042
Mailing Address - Country:US
Mailing Address - Phone:516-488-2750
Mailing Address - Fax:516-488-7407
Practice Address - Street 1:410 LAKEVILLE RD
Practice Address - Street 2:STE 300
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042
Practice Address - Country:US
Practice Address - Phone:516-488-2750
Practice Address - Fax:516-488-7407
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-30
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY154173207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01212115Medicaid
A65051Medicare UPIN
NY01212115Medicaid