Provider Demographics
NPI:1609971282
Name:MARTIN, ANITA-KAY (MD)
Entity Type:Individual
Prefix:DR
First Name:ANITA-KAY
Middle Name:
Last Name:MARTIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20507 HILLSIDE AVE STE 28
Mailing Address - Street 2:
Mailing Address - City:HOLLIS
Mailing Address - State:NY
Mailing Address - Zip Code:11423-2220
Mailing Address - Country:US
Mailing Address - Phone:718-217-9207
Mailing Address - Fax:718-217-9334
Practice Address - Street 1:20507 HILLSIDE AVE STE 28
Practice Address - Street 2:
Practice Address - City:HOLLIS
Practice Address - State:NY
Practice Address - Zip Code:11423-2220
Practice Address - Country:US
Practice Address - Phone:347-661-1125
Practice Address - Fax:718-217-9334
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY182057207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY100120588801OtherUNITEDHEALTHCARE MEDICADE
NY113616881OtherMULTIPLAN
NY1205888OtherUNITED HEALTH CARE
NY113616881Other1199
NY4C0398OtherHEALTHNET /PHS
NY468C72OtherEMPIRE BC/BS
NYP560962/1OtherOXFORD
NY0740446006OtherCIGNA
NY4C0398OtherHEALTHNET /PHS
NYP560962/1OtherOXFORD