Alina Ginzburg, MD
Individual provider Active NPI Pediatrics Physician · Montclair NJ, NJ
NPI 1417110693 · NPPES record last updated Dec 20, 2021
Key facts
- NPI
- 1417110693
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 247629 (NY)
- Practice address
- 48 S Park St Unit 519
Montclair NJ, NJ 07042 - Phone
- (201) 569-2400
- NPI assigned
- Jul 8, 2008
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA08459700 | NJ | MD | Pediatrics Physician |
| 247629 | NY | MD | Pediatrics Physician |
Interoperability endpoints
- alina.sumarokov@tenpeds.eclinicaldirectplus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 25MA08459700 | NJ | |
| Pediatrics Physician | 208000000X | 247629 | NY | Yes |
Addresses
Primary practice location
48 S Park St Unit 519
Montclair NJ, NJ 07042
Mailing address
48 S Park St Unit 519
Montclair NJ, NJ 07042
Other names
- Alina Sumarokov Khelifi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 20, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.