Provider Demographics
NPI:1417978131
Name:MARTOCCI, GREGORY A (DO)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:A
Last Name:MARTOCCI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:520 FRANKLIN AVE
Mailing Address - Street 2:SUITE 150
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530
Mailing Address - Country:US
Mailing Address - Phone:516-248-5107
Mailing Address - Fax:216-248-5109
Practice Address - Street 1:520 FRANKLIN AVE
Practice Address - Street 2:SUITE 150
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530
Practice Address - Country:US
Practice Address - Phone:516-248-5107
Practice Address - Fax:216-248-5109
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2278581208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics