Healthcare Provider Details

I. General information

NPI: 1013979558
Provider Name (Legal Business Name): MARINA MOVSHOVICH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2006
Last Update Date: 05/19/2023
Certification Date: 05/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 COURT ST FL 6
BROOKLYN NY
11201-4845
US

IV. Provider business mailing address

50 COURT ST FL 6
BROOKLYN NY
11201-4845
US

V. Phone/Fax

Practice location:
  • Phone: 718-522-3131
  • Fax:
Mailing address:
  • Phone: 718-522-3131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number223340
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: