Provider Demographics
NPI:1932417540
Name:KUSHNER, MARINA (MS, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:MARINA
Middle Name:
Last Name:KUSHNER
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2075 E 68TH ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-6009
Mailing Address - Country:US
Mailing Address - Phone:718-968-7866
Mailing Address - Fax:718-968-7918
Practice Address - Street 1:2075 E 68TH ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-6009
Practice Address - Country:US
Practice Address - Phone:718-968-7866
Practice Address - Fax:718-968-7918
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-16
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011189225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics