Provider Demographics
NPI:1780908673
Name:HAUPTMAN, MARTIN ARTHUR (MD)
Entity type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:ARTHUR
Last Name:HAUPTMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1 TIDE MILL RD
Mailing Address - Street 2:
Mailing Address - City:SAINT JAMES
Mailing Address - State:NY
Mailing Address - Zip Code:11780-9626
Mailing Address - Country:US
Mailing Address - Phone:631-265-3174
Mailing Address - Fax:631-265-9084
Practice Address - Street 1:1 TIDE MILL RD
Practice Address - Street 2:
Practice Address - City:SAINT JAMES
Practice Address - State:NY
Practice Address - Zip Code:11780-9626
Practice Address - Country:US
Practice Address - Phone:631-265-3174
Practice Address - Fax:631-265-9084
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-21
Last Update Date:2010-03-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY092331208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics