Gampon, Ian Martinez
Gampon, Ian Martinez is an individual health care provider with primary practice located at 7901 Broadway Room A1-9, Elmhurst NY 11373-1329. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine. Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine is his primary health care specialty. Gampon, Ian Martinez can be contacted via phone (718) 334-4952.Contact Information
Primary practice address
7901 Broadway Room A1-9
Elmhurst NY 11373-1329
Phone: (718) 334-4952
Fax: (718) 334-4815
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 227500 | New York |
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine | 2080P0204X | 227500 | New York |
Profile Details
NPI number | 1578591509 |
---|---|
LBN Legal business name | Gampon, Ian Martinez |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 29th, 2006 |
Last updated | Oct 23rd, 2007 - about 17 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1578591509 | NPPES |
New York | MEDICAID | 02408804 |
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