Provider Demographics
NPI:1184697518
Name:DI MARTINO, STEPHEN JOSEPH (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:JOSEPH
Last Name:DI MARTINO
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:535 EAST 70TH STREET
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021
Mailing Address - Country:US
Mailing Address - Phone:212-774-7016
Mailing Address - Fax:646-714-6310
Practice Address - Street 1:525 E 71ST ST
Practice Address - Street 2:7TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4828
Practice Address - Country:US
Practice Address - Phone:212-774-7016
Practice Address - Fax:646-714-6310
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-08
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY222472207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400101657Medicare PIN
NYI25750Medicare UPIN