Provider Demographics
NPI:1831188234
Name:ZILBERT, MARINA (DDS)
Entity type:Individual
Prefix:
First Name:MARINA
Middle Name:
Last Name:ZILBERT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 NOSTRAND AVE
Mailing Address - Street 2:STE 1P
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-4749
Mailing Address - Country:US
Mailing Address - Phone:718-252-2479
Mailing Address - Fax:718-252-2493
Practice Address - Street 1:2525 NOSTRAND AVE
Practice Address - Street 2:STE 1P
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-4749
Practice Address - Country:US
Practice Address - Phone:718-252-2479
Practice Address - Fax:718-252-2493
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046369-011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01662679Medicaid
NYD000663OtherAMERICHOICE