Provider Demographics
NPI:1700263720
Name:DUBOVSKA, MARIANNA (DO)
Entity Type:Individual
Prefix:
First Name:MARIANNA
Middle Name:
Last Name:DUBOVSKA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:GLOVERSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12078-1293
Mailing Address - Country:US
Mailing Address - Phone:518-773-5687
Mailing Address - Fax:518-773-5232
Practice Address - Street 1:99 E STATE ST
Practice Address - Street 2:
Practice Address - City:GLOVERSVILLE
Practice Address - State:NY
Practice Address - Zip Code:12078-1203
Practice Address - Country:US
Practice Address - Phone:518-773-5687
Practice Address - Fax:518-773-5687
Is Sole Proprietor?:No
Enumeration Date:2015-04-28
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY317102208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery