Marina Koulomzin, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

012561 Issued in NY

Practice address

5700 Arlington Ave
Apt 20L
Bronx, NY 10471-1503

Phone

(718) 432-0674

Fax

(718) 432-0674

NPI assigned

Jan 3, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Dr. Marina Koulomzin Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477610673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 ARLINGTON AVE",
            "address_2": "APT 20M",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104711503",
            "telephone_number": "718-432-0674",
            "fax_number": "718-432-0674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 ARLINGTON AVE",
            "address_2": "APT 20L",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104711503",
            "telephone_number": "718-432-0674",
            "fax_number": "718-432-0674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOULOMZIN",
        "first_name": "MARINA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "012561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARINA",
            "last_name": "KOULOMZIN",
            "prefix": "DR.",
            "credential": "PSY.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Zachah Koufalis
• Katherine Kougentakis, MS-CCC-SLP
• Michael Anthony Koui, DMD
• Ioannis Koulas, MD
• Koulis Tender Touch Occupational Therapy Services PLLC
• Vasilios Koulouris
• Naida Koura-Mola
• Aicha Kourouma, LPN
• Sarah Kourouma, LCSW
• Edem Koutodzo, LPN

• Psychologist in Bronx, NY
• Providers in Bronx, NY by specialty
• Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.