Individual
DR. IVAN DE MARTINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
535 E 70TH ST, NEW YORK, NY 10021-4823
(212) 774-2572
Mailing address
400 E 71ST ST APT 11N, NEW YORK, NY 10021-4814
(646) 361-4105
Taxonomy
Speciality
Code
Description
License number
State
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
NA
ZZ
Other
Enumeration date
06/18/2017
Last updated
06/18/2017
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