Provider Demographics
NPI:1477511129
Name:KAHN, MARTIN L (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:L
Last Name:KAHN
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 1:530 FIRST AVE
Mailing Address - Street 2:STE 4H
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6402
Mailing Address - Country:US
Mailing Address - Phone:212-263-7228
Mailing Address - Fax:212-263-8972
Practice Address - Street 1:530 FIRST AVE
Practice Address - Street 2:STE 4H
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6402
Practice Address - Country:US
Practice Address - Phone:212-263-7228
Practice Address - Fax:212-263-8972
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY92479207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
B77751Medicare UPIN
564061Medicare ID - Type Unspecified