Provider Demographics
NPI:1700618543
Name:KAMINSKI, MARRIYA GULED
Entity type:Individual
Prefix:
First Name:MARRIYA
Middle Name:GULED
Last Name:KAMINSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11442 KENTSHIRE WAY
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-7443
Mailing Address - Country:US
Mailing Address - Phone:571-598-7866
Mailing Address - Fax:
Practice Address - Street 1:11442 KENTSHIRE WAY
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-7443
Practice Address - Country:US
Practice Address - Phone:571-598-7866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator