Individual
MR. MARTIN AJAX CHRISPHONTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
750 FULTON ST, FARMINGDALE, NY 11735-3642
(631) 249-2765
(631) 249-3617
Mailing address
750 FULTON ST, FARMINGDALE, NY 11735-3642
(631) 249-2765
(631) 249-3617
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
190294
NY
2084P0800X
Psychiatry Physician
ME85871
FL
2084P0805X
Geriatric Psychiatry Physician
190294
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01810975
—
NY
Enumeration date
09/13/2005
Last updated
09/13/2019
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