Individual
DR. MARINA NEYSTAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
10124 QUEENS BLVD, SUITE A, FOREST HILLS, NY 11375-2703
(718) 261-8881
Mailing address
10124 QUEENS BLVD, SUITE A, FOREST HILLS, NY 11375-2703
(718) 261-8881
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
200915-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01724698
—
NY
01
—
200915
NYS LICENSE
NY
Enumeration date
09/16/2005
Last updated
06/22/2012
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