Provider Demographics
NPI:1386711182
Name:ZARETSKAYA, MARINA (MD)
Entity type:Individual
Prefix:
First Name:MARINA
Middle Name:
Last Name:ZARETSKAYA
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 1:1350 LOCUST ST
Mailing Address - Street 2:STE 402
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15219-4738
Mailing Address - Country:US
Mailing Address - Phone:412-232-8683
Mailing Address - Fax:412-232-8670
Practice Address - Street 1:1350 LOCUST ST
Practice Address - Street 2:#402
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15219-4738
Practice Address - Country:US
Practice Address - Phone:412-232-8683
Practice Address - Fax:412-232-8670
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD069227L2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1386711182OtherNPI
PA0018034950009Medicaid
PA1008614790001Medicaid
PA075841Medicare ID - Type UnspecifiedGROUP
PA037576SDDMedicare ID - Type UnspecifiedINDIVIDUAL
PA1008614790001Medicaid