Provider Demographics
NPI:1508934266
Name:ARTIOUKHINA, MARINA
Entity Type:Individual
Prefix:
First Name:MARINA
Middle Name:
Last Name:ARTIOUKHINA
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 1:2202 STEINWAY ST
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11105-1875
Mailing Address - Country:US
Mailing Address - Phone:718-423-0808
Mailing Address - Fax:718-204-6866
Practice Address - Street 1:71 METROPOLITAN OVAL
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-6402
Practice Address - Country:US
Practice Address - Phone:718-829-6436
Practice Address - Fax:718-829-6445
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002180207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02583246Medicaid
NYA400010646OtherBKLYN MEDICARE
NYA400010647Other26TH ST. MEDICARE
NY02583246Medicaid