Individual
IRINA CHURBAKOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6536 99TH ST, REGO PARK, NY 11374-4358
(718) 459-0700
Mailing address
6536 99TH ST, REGO PARK, NY 11374-4358
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F305291-1
NY
Other
Enumeration date
06/18/2019
Last updated
06/18/2019
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