Individual
DR. MARTIN STALLONE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD/MBA
Contact information
Practice address
101 DATES DR, ITHACA, NY 14850-1342
(607) 274-4189
Mailing address
101 DATES DR, ITHACA, NY 14850-1342
(607) 274-4189
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01061023A
IN
208M00000X
Hospitalist Physician
12340
RI
208M00000X
Hospitalist Physician
Primary
253091
NY
Other
Enumeration date
07/15/2006
Last updated
07/09/2012
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