Provider Demographics
NPI:1508032434
Name:KHITRIK-PALCHUK, MARINA Z (MD)
Entity Type:Individual
Prefix:
First Name:MARINA
Middle Name:Z
Last Name:KHITRIK-PALCHUK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARINA
Other - Middle Name:Z
Other - Last Name:KHITRIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:25 MARSTON ST APT 305
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01841-2358
Mailing Address - Country:US
Mailing Address - Phone:781-682-4066
Mailing Address - Fax:781-337-9619
Practice Address - Street 1:25 MARSTON ST
Practice Address - Street 2:SUITE #301
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01841-2310
Practice Address - Country:US
Practice Address - Phone:978-946-8230
Practice Address - Fax:978-946-8228
Is Sole Proprietor?:No
Enumeration Date:2008-04-30
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA235047207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology