Provider Demographics
NPI:1508376948
Name:GALINKIN, MARINA
Entity Type:Individual
Prefix:
First Name:MARINA
Middle Name:
Last Name:GALINKIN
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 1:7314 21ST AVE APT 2E
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-5908
Mailing Address - Country:US
Mailing Address - Phone:347-414-0775
Mailing Address - Fax:
Practice Address - Street 1:7314 21ST AVE APT 2E
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-5908
Practice Address - Country:US
Practice Address - Phone:347-414-0775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-11
Last Update Date:2017-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY060864183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist