Provider Demographics
NPI:1386646693
Name:BROWNSTEIN, MARTIN H (MD)
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:H
Last Name:BROWNSTEIN
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 1:2 N PLANDOME RD
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-3443
Mailing Address - Country:US
Mailing Address - Phone:516-944-3882
Mailing Address - Fax:516-883-2936
Practice Address - Street 1:2 N PLANDOME RD
Practice Address - Street 2:
Practice Address - City:PORT WASHINGTON
Practice Address - State:NY
Practice Address - Zip Code:11050-3443
Practice Address - Country:US
Practice Address - Phone:516-944-3882
Practice Address - Fax:516-883-2936
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY087998207ND0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY17946Medicare ID - Type Unspecified
NYC06352Medicare UPIN