Provider Demographics
NPI:1285664854
Name:KANOFF, MARTIN EARLE (DO)
Entity type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:EARLE
Last Name:KANOFF
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 8210
Mailing Address - Street 2:
Mailing Address - City:TURNERSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-8210
Mailing Address - Country:US
Mailing Address - Phone:856-232-0050
Mailing Address - Fax:856-232-0251
Practice Address - Street 1:1382 LANES MILL RD STE 201
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-3894
Practice Address - Country:US
Practice Address - Phone:732-994-4242
Practice Address - Fax:732-363-5164
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB04130200207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2330202Medicaid
NJ2330202Medicaid
NJ037040Medicare ID - Type UnspecifiedMEDICARE