Individual
IRINA OK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
7901 BROADWAY, ELMHURST, NY 11373-1329
(718) 334-3050
(718) 334-5006
Mailing address
7901 BROADWAY, ELMHURST, NY 11373-1329
(718) 334-3050
(718) 334-5006
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F309531
NY
Other
Enumeration date
04/22/2020
Last updated
04/22/2020
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