Provider Demographics
NPI:1649645839
Name:SAGINOR, MARINA
Entity type:Individual
Prefix:
First Name:MARINA
Middle Name:
Last Name:SAGINOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:446 KINGSTON AVE APT F1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11225-4622
Mailing Address - Country:US
Mailing Address - Phone:917-743-5190
Mailing Address - Fax:
Practice Address - Street 1:446 KINGSTON AVE APT F1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11225-4622
Practice Address - Country:US
Practice Address - Phone:917-743-5190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-14
Last Update Date:2024-10-08
Deactivation Date:2023-07-20
Deactivation Code:
Reactivation Date:2024-10-08
Provider Licenses
StateLicense IDTaxonomies
NY1209047222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist