Provider Demographics
NPI:1598991937
Name:MILLS, MARIKA C (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIKA
Middle Name:C
Last Name:MILLS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARIKA
Other - Middle Name:C
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3636 WALDO AVE
Mailing Address - Street 2:APT 5J
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-2247
Mailing Address - Country:US
Mailing Address - Phone:718-696-3015
Mailing Address - Fax:
Practice Address - Street 1:1000 WATERS PL
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-2701
Practice Address - Country:US
Practice Address - Phone:718-696-3015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-29
Last Update Date:2009-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251669-12084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry