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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578591509 NPPES
New York MEDICAID 02408804

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