Provider Demographics
NPI:1477585701
Name:CAMINS, MARTIN BRUCE (MD)
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:BRUCE
Last Name:CAMINS
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 1:205 E 68TH ST
Mailing Address - Street 2:STE T1-C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-5735
Mailing Address - Country:US
Mailing Address - Phone:212-570-0100
Mailing Address - Fax:212-570-0117
Practice Address - Street 1:205 E 68TH ST
Practice Address - Street 2:STE TIC
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021
Practice Address - Country:US
Practice Address - Phone:212-570-0100
Practice Address - Fax:212-570-0117
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY106683207T00000X
PA04226014207T00000X
NY1066831207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB12181Medicare UPIN
NY280521Medicare ID - Type Unspecified