| Doctor Name: | DR. MARTIN MICHAEL PROPPER |
| NPI Number: | 1013175116 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | 003576 |
| Business Practice Address: | 17 Barstow Rd Suite 400 Great Neck, NY - 110212213 |
| Business Phone Number: | 5164849184 |
| Business Fax Number: | |
| Mailing Address: | 17 Barstow Rd, Suite 400 GREAT NECK |
| State: | NY |
| Postal Code: | 110212213 |
| Phone Number: | 5164849184 |
| Fax Number: | |
| NPI Enumeration Date: | 05/27/2008 |
| NPI Last Update Date: | 05/27/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC2200X |
| License Number: | 003576 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical Child & Adolescent |
| Taxonomy Definition: | |