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Organization
MARTIN O GOTTLIEB MD
Active
Organization
MARTIN O GOTTLIEB MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARTIN O GOTTLIEB MD (OWNER)
(718) 979-9623
Entity
Organization
Contact information
Practice address
1005 MERRICK AVE, NORTH MERRICK, NY 11566-1033
(718) 979-9623
(718) 980-0628
Mailing address
1005 MERRICK AVE, NORTH MERRICK, NY 11566-1033
(718) 979-9623
(718) 980-0628
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
147430
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
147430
LICENSE
NY
Enumeration date
05/17/2007
Last updated
02/25/2009
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