Provider Demographics
NPI:1134226665
Name:ZABEZHANSKAYA, MARINA (MD)
Entity type:Individual
Prefix:DR
First Name:MARINA
Middle Name:
Last Name:ZABEZHANSKAYA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2511 OCEAN AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-3915
Mailing Address - Country:US
Mailing Address - Phone:718-332-6080
Mailing Address - Fax:
Practice Address - Street 1:2511 OCEAN AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-3915
Practice Address - Country:US
Practice Address - Phone:718-332-6080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-19
Last Update Date:2010-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY180704207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY029K8620Medicare ID - Type Unspecified