Active NPI
Marina Doulova
- Psychiatry Physician
- Forest Hills, NY
National Provider Identifier
1508904384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 256330
- Practice address
- 10 Greenway Ter
Forest Hills, NY 11375-5254 - Phone
- (718) 261-3232
- NPI assigned
- Feb 2, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | 256330 | NY | |
| Psychiatry Physician | 2084P0800X | 256330 | NY | Primary |
Addresses
Primary practice location
10 Greenway Ter
Forest Hills, NY 11375-5254
Mailing address
10 Greenway Ter
Abc Psychiatric Services
Forest Hills, NY 11375-5254
Phone (718) 261-3232
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 256330 | Other | NY | NONE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 256330 | NY | MD | Child & Adolescent Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280966400000",
"number": "1508904384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 GREENWAY TER",
"address_2": "ABC PSYCHIATRIC SERVICES",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113755254",
"telephone_number": "718-261-3232"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 GREENWAY TER",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113755254",
"telephone_number": "718-261-3232"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOULOVA",
"first_name": "MARINA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-02",
"last_updated": "2010-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "NY",
"license": "256330",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "256330",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NONE",
"identifier": "256330",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Forest Hills, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.