Provider Demographics
NPI:1962550046
Name:DOFT, MARTIN (MD)
Entity type:Individual
Prefix:
First Name:MARTIN
Middle Name:
Last Name:DOFT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 EAST 9TH ST.
Mailing Address - Street 2:12F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-6311
Mailing Address - Country:US
Mailing Address - Phone:212-677-2493
Mailing Address - Fax:
Practice Address - Street 1:55 E 9TH ST
Practice Address - Street 2:12F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-6311
Practice Address - Country:US
Practice Address - Phone:212-677-2493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0988702084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB17252Medicare UPIN