Provider Demographics
NPI:1437821808
Name:KATOLIS, MARINA CHRISTINA (MS ED)
Entity Type:Individual
Prefix:
First Name:MARINA
Middle Name:CHRISTINA
Last Name:KATOLIS
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:MARINA
Other - Middle Name:
Other - Last Name:KATOLIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS ED
Mailing Address - Street 1:168 HILL ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:NY
Mailing Address - Zip Code:11968-5337
Mailing Address - Country:US
Mailing Address - Phone:631-283-3272
Mailing Address - Fax:631-283-3356
Practice Address - Street 1:168 HILL ST
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:NY
Practice Address - Zip Code:11968-5337
Practice Address - Country:US
Practice Address - Phone:631-283-3272
Practice Address - Fax:631-283-3356
Is Sole Proprietor?:No
Enumeration Date:2021-10-04
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist