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Individual

DR. IRINA GONCHARUK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
8405 BAY PKWY, BROOKLYN, NY 11214-3359
(718) 331-6100
(718) 331-1723
Mailing address
8405 BAY PKWY, BROOKLYN, NY 11214-3359
(718) 331-6100
(718) 331-1723

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
049909
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02276680
NY
Enumeration date
11/06/2006
Last updated
07/08/2007
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