Martin Diamond, D.O.
Individual provider Active NPI Family Medicine Physician · Massapequa PK, NY
NPI 1972874873 · NPPES record last updated Jan 24, 2012
Key facts
- NPI
- 1972874873
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 89462 (NY)
- Practice address
- 248 Harbor LN
Massapequa PK, NY 11762-4011 - Phone
- (516) 572-8836
- NPI assigned
- Jan 24, 2012
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 89462 | NY | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 89462 | NY | Yes |
Addresses
Primary practice location
248 Harbor LN
Massapequa PK, NY 11762-4011
Mailing address
248 Harbor LN
Massapequa Park, NY 11762-4011
Phone (516) 572-8836
Other providers in Massapequa PK, NY
- Dorothy Ann Colucci Festa
- Maxine Andrea Lewis
- Jim A Nesdill
- Erin Mary Scansarole
- Natalie Nicole Spellman
All providers in Massapequa PK, NY · Family Medicine Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 24, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.