Provider Demographics
NPI:1780654178
Name:KAPLAN, MARTIN P (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:P
Last Name:KAPLAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:12 MEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:PORT JEFFERSON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11776-1588
Mailing Address - Country:US
Mailing Address - Phone:631-331-1710
Mailing Address - Fax:631-928-4910
Practice Address - Street 1:12 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:PORT JEFFERSON STATION
Practice Address - State:NY
Practice Address - Zip Code:11776-1588
Practice Address - Country:US
Practice Address - Phone:631-331-1710
Practice Address - Fax:631-928-4910
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY116716-1208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00411849Medicaid