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General NPI Number Information
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NPI Number | 1043482706
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Entity Type | Individual
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Provider Name | MARINA OSTROUKHOVA MD
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Gender | Female
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Dates
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Enumeration Date | 04/01/2008
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Last Update Date | 05/01/2014
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Provider Practice Location Address
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Address Line | 1329 LUSITANA ST STE 603
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City | HONOLULU
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State | HI
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Zip | 96813-2431
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Country | US
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Telephone | 808-521-2712
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Fax | 808-537-5823
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Provider Business Mailing Address
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Address Line | 2575 KUHIO AVE APT 904
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City | HONOLULU
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State | HI
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Zip | 96815-3919
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Country | US
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Telephone | 585-354-7411
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | MD15662
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD15662
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License Number State | HI
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