Provider Demographics
NPI:1720149537
Name:FOX, MARTIN LEON (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:LEON
Last Name:FOX
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 1:109 E 38TH STREET
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-2601
Mailing Address - Country:US
Mailing Address - Phone:212-686-3410
Mailing Address - Fax:212-686-3431
Practice Address - Street 1:109 E 38TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-2601
Practice Address - Country:US
Practice Address - Phone:212-686-3410
Practice Address - Fax:212-686-3431
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY89553207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
P381260OtherOXFORD
0M0452OtherHEALTH NET
MF04347210OtherBCBS
MF04347210OtherBCBS
P381260OtherOXFORD