Basic Information
| Provider Information | |||||||||
| NPI: | 1659632628 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KIOKO | ||||||||
| FirstName: | MARILYN | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 66 ROCKWELL PL APT 5F | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112171199 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9177245329 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 121 DEKALB AVE | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112015493 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7182508000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/06/2012 | ||||||||
| LastUpdateDate: | 01/24/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/24/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 312829 | NY | N | Allopathic & Osteopathic Physicians | Pediatrics | 2080P0203X | 036128655 | IL | N | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Critical Care Medicine | 2080P0203X | 312829 | NY | N | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Critical Care Medicine | 207P00000X | Q8532 | TX | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.