Provider Demographics
NPI:1023273158
Name:SHAINSKY, MARINA (MD)
Entity type:Individual
Prefix:
First Name:MARINA
Middle Name:
Last Name:SHAINSKY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARINA
Other - Middle Name:
Other - Last Name:PETLAKH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:722 E BUTLER PIKE
Mailing Address - Street 2:
Mailing Address - City:AMBLER
Mailing Address - State:PA
Mailing Address - Zip Code:19002-2310
Mailing Address - Country:US
Mailing Address - Phone:215-643-7800
Mailing Address - Fax:
Practice Address - Street 1:722 E BUTLER PIKE
Practice Address - Street 2:
Practice Address - City:AMBLER
Practice Address - State:PA
Practice Address - Zip Code:19002-2310
Practice Address - Country:US
Practice Address - Phone:215-643-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-29
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA193673207R00000X
PAMD4471782084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine