Provider Demographics
NPI:1104954734
Name:ARTUSHENIA, MARILYN J (MD)
Entity type:Individual
Prefix:DR
First Name:MARILYN
Middle Name:J
Last Name:ARTUSHENIA
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 1:162 ALLYN RD
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:CT
Mailing Address - Zip Code:06756-1312
Mailing Address - Country:US
Mailing Address - Phone:860-672-4322
Mailing Address - Fax:
Practice Address - Street 1:162 ALLYN RD
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:CT
Practice Address - Zip Code:06756-1312
Practice Address - Country:US
Practice Address - Phone:860-672-4322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT026228207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine