Basic Information
| Provider Information | |||||||||
| NPI: | 1508934266 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | ARTIOUKHINA | ||||||||
| FirstName: | MARINA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2202 STEINWAY ST | ||||||||
| Address2: | |||||||||
| City: | ASTORIA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 111051875 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7184230808 | ||||||||
| FaxNumber: | 7182046866 | ||||||||
| Practice Location | |||||||||
| Address1: | 71 METROPOLITAN OVAL | ||||||||
| Address2: | |||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104626402 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7188296436 | ||||||||
| FaxNumber: | 7188296445 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/01/2006 | ||||||||
| LastUpdateDate: | 05/26/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 002180 | NY | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 02583246 | 05 | NY | MEDICAID | A400010646 | 01 | NY | BKLYN MEDICARE | OTHER | A400010647 | 01 | NY | 26TH ST. MEDICARE | OTHER |