Provider Demographics
NPI:1154793123
Name:FLEMING, MARTIN (DC)
Entity type:Individual
Prefix:
First Name:MARTIN
Middle Name:
Last Name:FLEMING
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 W 21ST ST
Mailing Address - Street 2:# 1
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-3022
Mailing Address - Country:US
Mailing Address - Phone:212-727-2046
Mailing Address - Fax:
Practice Address - Street 1:49 W 12TH ST STE 1E
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8530
Practice Address - Country:US
Practice Address - Phone:646-799-2875
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-29
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX012725-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor