Provider Demographics
NPI:1306924287
Name:CALTON, MARTIN JOEL (MD)
Entity type:Individual
Prefix:
First Name:MARTIN
Middle Name:JOEL
Last Name:CALTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:137 BROADWAY
Mailing Address - Street 2:SUITE C
Mailing Address - City:AMITYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11701
Mailing Address - Country:US
Mailing Address - Phone:631-598-4799
Mailing Address - Fax:631-598-7498
Practice Address - Street 1:137 BROADWAY
Practice Address - Street 2:SUITE C
Practice Address - City:AMITYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11701
Practice Address - Country:US
Practice Address - Phone:631-598-4799
Practice Address - Fax:631-598-7498
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY11735512084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
C05791Medicare UPIN
13A511Medicare ID - Type Unspecified