Provider Demographics
NPI:1417110693
Name:GINZBURG, ALINA (MD)
Entity Type:Individual
Prefix:
First Name:ALINA
Middle Name:
Last Name:GINZBURG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALINA
Other - Middle Name:
Other - Last Name:SUMAROKOV KHELIFI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:48 S PARK ST UNIT 519
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR NJ
Mailing Address - State:NJ
Mailing Address - Zip Code:07042
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:48 S PARK ST UNIT 519
Practice Address - Street 2:
Practice Address - City:MONTCLAIR NJ
Practice Address - State:NJ
Practice Address - Zip Code:07042
Practice Address - Country:US
Practice Address - Phone:201-569-2400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-08
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08459700208000000X
NY247629208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics