Provider Demographics
NPI:1861851693
Name:ROSS, MARINA (MS)
Entity Type:Individual
Prefix:
First Name:MARINA
Middle Name:
Last Name:ROSS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 W 88TH ST
Mailing Address - Street 2:APT. 10E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-1716
Mailing Address - Country:US
Mailing Address - Phone:917-669-8228
Mailing Address - Fax:
Practice Address - Street 1:255 W 88TH ST
Practice Address - Street 2:APT. 10E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-1716
Practice Address - Country:US
Practice Address - Phone:917-669-8228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-22
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program