Provider Demographics
NPI:1740455799
Name:INGBER, MARTIN (RPH)
Entity type:Individual
Prefix:
First Name:MARTIN
Middle Name:
Last Name:INGBER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:254 S MAIN ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-3340
Mailing Address - Country:US
Mailing Address - Phone:845-639-4952
Mailing Address - Fax:845-639-4955
Practice Address - Street 1:55 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:COLD SPRING
Practice Address - State:NY
Practice Address - Zip Code:10516-2604
Practice Address - Country:US
Practice Address - Phone:845-265-6352
Practice Address - Fax:845-265-6076
Is Sole Proprietor?:No
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025384-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist