MEDICARE: DR. MARINA KHARAZ M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	197130	NY
2	2084P0800X	Psychiatry Physician	25MA06139200	NJ

General Provider Information

NPI Number	:	1194790899
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARINA KHARAZ M.D.

Provider Business Mailing Address
First Line	:	9 SHERWOOD CT
Second Line	:
City	:	HOLMDEL
State	:	NJ
Zip	:	07733-2057
Country	:	US
Telephone Number	:	917-748-8962
Fax Number	:	732-332-0037

Provider Business Practice Location Address
First Line	:	725 AIRPORT RD
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-5968
Country	:	US
Telephone Number	:	732-367-4700
Fax Number	:	732-364-2253

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/17/2006
Last Update Date	:	12/14/2025

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