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General NPI Number Information
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NPI Number | 1659593317
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Entity Type | Individual
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Provider Name | MARINA NAKIC MD, PHD
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Gender | Female
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 09/14/2009
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Provider Practice Location Address
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Address Line | 300 GEORGE ST STE 901
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City | NEW HAVEN
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State | CT
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Zip | 06511-6662
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Country | US
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Telephone | 202-441-6780
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Fax |
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Provider Business Mailing Address
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Address Line | 300 GEORGE ST STE 901
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City | NEW HAVEN
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State | CT
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Zip | 06511-6662
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Country | US
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Telephone |
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 047320
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License Number State | CT
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