Provider Demographics
NPI:1922210806
Name:MARTIN WHITEMAN D.O. P.A.
Entity Type:Organization
Organization Name:MARTIN WHITEMAN D.O. P.A.
Other - Org Name:MARTIN WHITEMAN D.O. P.A.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:732-606-4754
Mailing Address - Street 1:PO BOX 326
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07417-0326
Mailing Address - Country:US
Mailing Address - Phone:732-606-4754
Mailing Address - Fax:201-847-0059
Practice Address - Street 1:217 FALLING OAKS RD
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-8408
Practice Address - Country:US
Practice Address - Phone:732-606-4754
Practice Address - Fax:201-847-0059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA591812084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5458102Medicaid
NJ5458102Medicaid
NJ097104Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER