Healthcare Provider Details

I. General information

NPI: 1194790899
Provider Name (Legal Business Name): MARINA KHARAZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 12/14/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 AIRPORT RD
LAKEWOOD NJ
08701-5968
US

IV. Provider business mailing address

9 SHERWOOD CT
HOLMDEL NJ
07733-2057
US

V. Phone/Fax

Practice location:
  • Phone: 732-367-4700
  • Fax: 732-364-2253
Mailing address:
  • Phone: 917-748-8962
  • Fax: 732-332-0037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number197130
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number25MA06139200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: