Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XS0117X | Orthopaedic Spine Surgeon | 020966 | NY |
NPI | 1295256725 |
---|---|
Provider Name | Mr. Luke Martinic |
First Address | North Tonawanda, NY 14120-9705 |
Second Address | Buffalo, NY 14201-1435 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2017 |
Last Update Date | 17/03/2018 |