Provider Demographics
NPI:1871982793
Name:DESKIN, MARINA
Entity type:Individual
Prefix:
First Name:MARINA
Middle Name:
Last Name:DESKIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARINA
Other - Middle Name:
Other - Last Name:SHRAYBMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:50 BARR LN
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-4939
Mailing Address - Country:US
Mailing Address - Phone:845-659-3112
Mailing Address - Fax:
Practice Address - Street 1:1053 SAW MILL RIVER RD
Practice Address - Street 2:
Practice Address - City:ARDSLEY
Practice Address - State:NY
Practice Address - Zip Code:10502-1048
Practice Address - Country:US
Practice Address - Phone:914-674-0733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-15
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1810592171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor