Provider Demographics
NPI:1205860038
Name:BARANDES, MARTIN (MD)
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:
Last Name:BARANDES
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 1:155 E 76TH ST OFC 5
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-2810
Mailing Address - Country:US
Mailing Address - Phone:212-249-0622
Mailing Address - Fax:212-249-0217
Practice Address - Street 1:155 E 76TH ST OFC 5
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-2810
Practice Address - Country:US
Practice Address - Phone:212-249-0622
Practice Address - Fax:212-249-1044
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY095085207RE0101X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400112113Medicare PIN
NY371624OtherMVP (MOHAWK VALLEY PLAN)
NY657941Medicare PIN
NY000000047274OtherGHI HMO
NY4233139OtherAETNA/US HEALTHCARE
NY0061064OtherAETNA/US HEALTHCARE HMO
NYMB06579410OtherEMPIRE-BC/BS
GAP00182628Medicare PIN
NY095085OtherNYS MEDICAL LICENSE #
NYB17614Medicare UPIN
NY095085A35OtherHEALTHFIRST
NYNS227OtherOXFORD HEALTH PLAN
NY0663229OtherCIGNA
NY0C3279OtherHEALTH NET OF NE