Provider Demographics
NPI:1609908532
Name:MARTIN, TAMAR JEAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TAMAR
Middle Name:JEAN
Last Name:MARTIN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 TALLMADGE PL
Mailing Address - Street 2:
Mailing Address - City:MECHANICVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12118-2320
Mailing Address - Country:US
Mailing Address - Phone:518-664-0739
Mailing Address - Fax:
Practice Address - Street 1:53 TALLMADGE PL
Practice Address - Street 2:
Practice Address - City:MECHANICVILLE
Practice Address - State:NY
Practice Address - Zip Code:12118-2320
Practice Address - Country:US
Practice Address - Phone:518-664-0739
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047898183500000X, 1835G0303X, 1835N1003X, 1835P1200X, 1835P1300X, 1835X0200X
MA24929183500000X, 1835G0303X, 1835N1003X, 1835P1200X, 1835P1300X, 1835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist
Not Answered1835G0303XPharmacy Service ProvidersPharmacistGeriatric
Not Answered1835N1003XPharmacy Service ProvidersPharmacistNutrition Support
Not Answered1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
Not Answered1835P1300XPharmacy Service ProvidersPharmacistPsychiatric
Not Answered1835X0200XPharmacy Service ProvidersPharmacistOncology