Provider Demographics
NPI:1316214570
Name:SHARFSHTEYN, MARINA (OTR/L)
Entity Type:Individual
Prefix:
First Name:MARINA
Middle Name:
Last Name:SHARFSHTEYN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:390 KINGS HWY
Mailing Address - Street 2:APT. 2C
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-1614
Mailing Address - Country:US
Mailing Address - Phone:347-603-3312
Mailing Address - Fax:
Practice Address - Street 1:390 KINGS HWY
Practice Address - Street 2:APT. 2C
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-1614
Practice Address - Country:US
Practice Address - Phone:347-603-3312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-16
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017083225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist