Provider Demographics
NPI:1457372526
Name:TSIRLIN, MARAT (MD)
Entity Type:Individual
Prefix:DR
First Name:MARAT
Middle Name:
Last Name:TSIRLIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 OCEAN VIEW AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-6828
Mailing Address - Country:US
Mailing Address - Phone:718-332-7551
Mailing Address - Fax:718-332-6385
Practice Address - Street 1:401 OCEAN VIEW AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-6828
Practice Address - Country:US
Practice Address - Phone:718-332-7551
Practice Address - Fax:718-332-6385
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY203451207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01666820Medicaid
NY01666820Medicaid
NY468521Medicare ID - Type Unspecified