Provider Demographics
NPI:1598824971
Name:KURIAN, MARINA S (MD)
Entity Type:Individual
Prefix:DR
First Name:MARINA
Middle Name:S
Last Name:KURIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1060 5TH AVE
Mailing Address - Street 2:STE 1B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-0104
Mailing Address - Country:US
Mailing Address - Phone:917-261-2061
Mailing Address - Fax:888-300-9429
Practice Address - Street 1:161 MADISON AVE RM 9SE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016
Practice Address - Country:US
Practice Address - Phone:917-261-2061
Practice Address - Fax:888-300-9429
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY211000208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
77L252Medicare ID - Type Unspecified
F53836Medicare UPIN