Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 25MA02573300 | NJ |
N | 207RA0201X | Internist - Allergy & Immunology | 109191 | NY |
NPI | 1467587485 |
---|---|
Provider Name | Dr. Martin S Pine |
First Address | New York, NY 10016-3893 |
Second Address | New York, NY 10016-3893 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2007 |
Last Update Date | 05/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0533491 | (05) | NJ |
1062082 | WELLCARE (01) | NJ |
132963926 | TAX ID (01) | NY |
1467587485 | AMERIGROUP (01) | NJ |
1467587485 | COVENTRY HEALTH-FIRST HEALTH (01) | NJ |
323802 | BLUE CROSS BLUE SHEILD (01) | NY |
3404949000 | AMERIHEALTH (01) | NJ |
392724 | U.S. FAMILY HEALTH (01) | NJ |
4316513 | AETNA PPO (01) | NJ |
4411182 | EMBLEM HEALTH GHI (01) | NJ |
5140091 | AETNA HMO (01) | NJ |
8833753 | CIGNA, GREATWEST (01) | NJ |
CO8476 | (02) | NY |
P571240 | OXFORD (01) | NY |