Individual
MARSIYANA MISTIKA HENRICUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
150 55TH ST, BROOKLYN, NY 11220-2508
(718) 630-7000
(718) 630-8515
Mailing address
150 55TH ST, BROOKLYN, NY 11220-2508
(718) 630-7000
(718) 630-8515
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
320405
NY
Other
Enumeration date
11/12/2019
Last updated
03/22/2023
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