Provider Demographics
NPI:1437326550
Name:TABAKSBLAT, MARTIN YARON (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:YARON
Last Name:TABAKSBLAT
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 1:242 W PARKWAY
Mailing Address - Street 2:
Mailing Address - City:POMPTON PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07444-1029
Mailing Address - Country:US
Mailing Address - Phone:973-831-7455
Mailing Address - Fax:973-831-7585
Practice Address - Street 1:242 W PARKWAY
Practice Address - Street 2:
Practice Address - City:POMPTON PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07444-1029
Practice Address - Country:US
Practice Address - Phone:973-831-7455
Practice Address - Fax:973-831-7585
Is Sole Proprietor?:No
Enumeration Date:2008-05-08
Last Update Date:2018-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09436100207RC0000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program