Provider Demographics
NPI:1689978256
Name:SIGALOVSKAYA KHENKIN, MARINA (AUD)
Entity Type:Individual
Prefix:DR
First Name:MARINA
Middle Name:
Last Name:SIGALOVSKAYA KHENKIN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:MARINA
Other - Middle Name:
Other - Last Name:SIGALOVSKAYA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1901 1ST AVE
Mailing Address - Street 2:6TH FLOOR OPD BUILDING ROOM 6D11
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-7404
Mailing Address - Country:US
Mailing Address - Phone:212-423-6148
Mailing Address - Fax:
Practice Address - Street 1:1901 1ST AVE
Practice Address - Street 2:6TH FLOOR OPD BUILDING ROOM 6D11
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-7404
Practice Address - Country:US
Practice Address - Phone:212-423-6148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-22
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002323231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist