Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223S0112X | Oral and Maxillofacial Surgeon | 059208 | NY |
Y | 204E00000X | Oral & Maxillofacial Surgeon | 287603 | NY |
NPI | 1396035507 |
---|---|
Provider Name | Dr. Hunter J. Martin |
First Address | Suffern, NY 10901-4910 |
Second Address | Suffern, NY 10901-4910 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2011 |
Last Update Date | 02/11/2017 |