Chrisphonte, Martin Ajax

Chrisphonte, Martin Ajax is an sole proprietor health care provider with primary practice located at 750 Fulton St , Farmingdale NY 11735-3642. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Geriatric Psychiatry, Allopathic & Osteopathic Physicians / Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Chrisphonte, Martin Ajax can be contacted via phone (631) 249-2765.

Contact Information

Primary practice address
750 Fulton St Farmingdale NY 11735-3642
Phone: (631) 249-2765
Fax: (631) 249-3617
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Geriatric Psychiatry 2084P0805X 190294 New York
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X ME85871 Florida
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 190294 New York

Profile Details

NPI number 1619962966
LBN Legal business name Chrisphonte, Martin Ajax
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 13th, 2005
Last updated Sep 13th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1619962966 NPPES
New York MEDICAID 01810975

Popular Providers