Provider Demographics
NPI:1578795480
Name:SHIKHMAN, MARINA (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARINA
Middle Name:
Last Name:SHIKHMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 PALISADE AVE
Mailing Address - Street 2:#25C
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-5471
Mailing Address - Country:US
Mailing Address - Phone:917-757-0381
Mailing Address - Fax:
Practice Address - Street 1:1530 PALISADE AVE
Practice Address - Street 2:#25C
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-5471
Practice Address - Country:US
Practice Address - Phone:917-757-0381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-12
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY68 017884103T00000X
NJ4788103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist