Individual
DR. IRINA A VASILYEVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD PHD
Contact information
Practice address
1001 POTRERO AVE, RM 1X55, SAN FRANCISCO, CA 94110-3518
(415) 206-5871
(415) 206-4004
Mailing address
250 GORGE RD #8C, CLIFFSIDE PARK, NJ 07010
(201) 724-8178
(201) 917-3447
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
245445
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A925040
—
CA
Enumeration date
06/11/2006
Last updated
09/29/2017
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