MARYNA MOOTOO PA NPI 1316318835

NPI Information

NPI: 1316318835
Provider Name: MARYNA MOOTOO, PA
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
4802 10TH AVE
BROOKLYN, NY
ZIP 11219
Phone: (718) 283-8958
Get Directions

Maryna Mootoo, PA is a medical physician assistant in Brooklyn, NY with 14 years of experience. Maryna Mootoo, PA NPI is 1316318835. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4802 10TH AVE
BROOKLYN, NY
ZIP 11219-916
Phone: (718) 283-8958

The NPI 1316318835 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/9/2015 and was last updated on 3/8/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	019123	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	HO4400	OTHER		OXFORD
2	000057	OTHER	NEW YORK	BLUE CROSS
3	IC0023	OTHER		PHYSICIANS HEALTH
4	02998736	MEDICAID	NEW YORK
5	000502001	OTHER		AMERICHOICE
6	0007008	OTHER		AETNAUSHEALTHCARE
7	71002	OTHER		ELDERPLAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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