Provider Demographics
NPI:1417595554
Name:LIVSHITS, MARINA
Entity Type:Individual
Prefix:
First Name:MARINA
Middle Name:
Last Name:LIVSHITS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 E 13TH ST APT 3H
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-7181
Mailing Address - Country:US
Mailing Address - Phone:347-866-2868
Mailing Address - Fax:
Practice Address - Street 1:1550 E 13TH ST APT 3H
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-7181
Practice Address - Country:US
Practice Address - Phone:347-866-2868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-19
Last Update Date:2019-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist