Provider Demographics
NPI:1447358536
Name:MARTIN MORELL MD PC
Entity type:Organization
Organization Name:MARTIN MORELL MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MORELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-724-5353
Mailing Address - Street 1:4401 MIDDLE SETTLEMENT RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:NEW HARTFORD
Mailing Address - State:NY
Mailing Address - Zip Code:13413-5319
Mailing Address - Country:US
Mailing Address - Phone:315-724-5353
Mailing Address - Fax:315-724-5255
Practice Address - Street 1:4401 MIDDLE SETTLEMENT RD
Practice Address - Street 2:SUITE 106
Practice Address - City:NEW HARTFORD
Practice Address - State:NY
Practice Address - Zip Code:13413-5319
Practice Address - Country:US
Practice Address - Phone:315-724-5353
Practice Address - Fax:315-724-5255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY196401207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG52355Medicare UPIN
NYBA0840Medicare UPIN