Provider Demographics
NPI:1609051879
Name:MARTINO, SUSAN ANTONINA (MD)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:ANTONINA
Last Name:MARTINO
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Gender:F
Credentials:MD
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Mailing Address - Street 1:HUDSON VISTA MEDICAL, PC
Mailing Address - Street 2:70 DUBOIS STREET, 5TH FLOOR ADMIN
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550
Mailing Address - Country:US
Mailing Address - Phone:845-458-4853
Mailing Address - Fax:845-458-4435
Practice Address - Street 1:HUDSON VISTA MEDICAL, PC
Practice Address - Street 2:70 DUBOIS STREET
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550
Practice Address - Country:US
Practice Address - Phone:845-458-4853
Practice Address - Fax:845-458-4808
Is Sole Proprietor?:No
Enumeration Date:2008-01-07
Last Update Date:2018-12-06
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Provider Licenses
StateLicense IDTaxonomies
NYF3045551363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health