Provider Demographics
NPI:1386790038
Name:TOURKOVA, MARINA (MD)
Entity type:Individual
Prefix:
First Name:MARINA
Middle Name:
Last Name:TOURKOVA
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 1:0-14 28TH ST
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-3707
Mailing Address - Country:US
Mailing Address - Phone:201-703-9893
Mailing Address - Fax:
Practice Address - Street 1:2033 WOOD ST STE 220
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237-7927
Practice Address - Country:US
Practice Address - Phone:941-677-3366
Practice Address - Fax:941-677-3367
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA074748002084P0800X
FLME1124132084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ9051805Medicaid
066887Medicare ID - Type Unspecified
NJ9051805Medicaid