Provider Demographics
NPI:1902849730
Name:STEIN, MARTIN G (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:G
Last Name:STEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 E 55TH ST
Mailing Address - Street 2:SUITE 107
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-4148
Mailing Address - Country:US
Mailing Address - Phone:212-249-2704
Mailing Address - Fax:
Practice Address - Street 1:305 E 55TH ST
Practice Address - Street 2:SUITE 107
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-4148
Practice Address - Country:US
Practice Address - Phone:212-249-2704
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY90979207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYZD 61936 RMedicaid
NYZD 61936 RMedicaid
NYD47651Medicare UPIN