Provider Demographics
NPI:1962538223
Name:MARTINO, VINCENT J (DC)
Entity type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:J
Last Name:MARTINO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:33 GREENWICH AVE
Mailing Address - Street 2:SUITE 1-C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-2701
Mailing Address - Country:US
Mailing Address - Phone:212-243-7800
Mailing Address - Fax:212-463-7727
Practice Address - Street 1:33 GREENWICH AVE
Practice Address - Street 2:SUITE 1-C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014-2701
Practice Address - Country:US
Practice Address - Phone:212-243-7800
Practice Address - Fax:212-463-7727
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX6609111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5745702OtherCIGNA PROVIDER ID
NYP830237OtherOXFORD PROVIDER ID
NY323683OtherACN PROVIDER ID