Individual
DR. MARTIN DEAN DINER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D
Contact information
Practice address
1155C BRIDGEHAMPTON SAG HARBOR TURNPIKE, BRIDGEHAMPTON, NY 11932
(631) 725-2132
(631) 237-4967
Mailing address
PO BOX 578, SAG HARBOR, NY 11963-0012
(631) 725-2132
(631) 237-4967
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
011418
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011418
LICENSE
NY
01
—
31149
NATIONAL REGISTER
—
01
—
PSY6665
INACTIVE LICENSE
CA
Enumeration date
07/02/2007
Last updated
12/30/2009
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