Individual
MARINE PETRIASHVILI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
760 BROADWAY, BROOKLYN, NY 11206-5317
(718) 963-8496
Mailing address
3531 85TH ST APT 3J, JACKSON HEIGHTS, NY 11372-5521
(718) 803-8509
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
271189
NY
Other
Enumeration date
10/13/2006
Last updated
09/18/2018
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