MEDICARE: MARYNA POHREBNIUK

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	246Z00000X	Other Specialist/Technologist	1867627	TX

General Provider Information

NPI Number	:	1710795075
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARYNA POHREBNIUK

Provider Business Mailing Address
First Line	:	13740 RESEARCH BLVD STE P2
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78750-1835
Country	:	US
Telephone Number	:	323-672-7988
Fax Number	:

Provider Business Practice Location Address
First Line	:	13740 RESEARCH BLVD STE P2
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78750-1835
Country	:	US
Telephone Number	:	323-672-7988
Fax Number	:

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

Provider Enumeration Date	:	12/19/2024
Last Update Date	:	12/19/2024

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Directions to “ MARYNA POHREBNIUK ” Practice Location

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