Provider Demographics
NPI:1891818225
Name:FROMMER, MARTIN S (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:S
Last Name:FROMMER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:160 E 88TH ST
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-2233
Mailing Address - Country:US
Mailing Address - Phone:212-876-9214
Mailing Address - Fax:212-208-2968
Practice Address - Street 1:160 E 88TH ST
Practice Address - Street 2:SUITE 1A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-2233
Practice Address - Country:US
Practice Address - Phone:212-876-9214
Practice Address - Fax:212-208-2968
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005308103TP0814X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis