Provider Demographics
NPI:1508800335
Name:DR MARINA KHARAZ PSYCHIATRY, PC
Entity Type:Organization
Organization Name:DR MARINA KHARAZ PSYCHIATRY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:KHARAZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-332-0018
Mailing Address - Street 1:9 SHERWOOD CT
Mailing Address - Street 2:
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-2057
Mailing Address - Country:US
Mailing Address - Phone:732-332-0018
Mailing Address - Fax:732-332-0037
Practice Address - Street 1:2625 E 14TH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-3973
Practice Address - Country:US
Practice Address - Phone:718-891-7800
Practice Address - Fax:718-332-7246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWFW731Medicare ID - Type Unspecified