Provider Demographics
NPI:1902125974
Name:MARIN, MONICA TEODORA (MD)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:TEODORA
Last Name:MARIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 ARLO RD
Mailing Address - Street 2:APT 1A
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10301-3875
Mailing Address - Country:US
Mailing Address - Phone:917-330-5953
Mailing Address - Fax:
Practice Address - Street 1:1200 CHILDRENS AVE STE 4D
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-4637
Practice Address - Country:US
Practice Address - Phone:405-271-6764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-28
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program