Individual provider · NPI-1

Dr. Martin R Chavez, MD

Obstetrics & Gynecology, Maternal & Fetal Medicine · Mineola, NY

NPI number1356411375

StatusActive

Last updated in NPPESMar 8, 2021

Details

NPI: 1356411375
Entity type: Individual (NPI-1)
Name: Dr. Martin R Chavez
Credential: MD
Sex: Male
Sole proprietor: No
Enumeration date: Nov 8, 2006
Certification date: Mar 8, 2021
Last updated: Mar 8, 2021

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207VM0101X	Obstetrics & Gynecology, Maternal & Fetal Medicine	25MA06683400	NJ	Yes

Practice location

120 Mineola Blvd
Suite 100
Mineola, NY 11501-4064

Phone 516-663-3010 · Fax 516-663-3026

Mailing address

700 Hicksville Rd
Suite 204
Bethpage, NY 11714-3471

Phone 516-576-6106 · Fax 516-576-5801

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