Individual
MRS. IRINA CHAIKHOUTDINOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1513 VOORHIES AVE, BROOKLYN, NY 11235-3913
(718) 332-4440
(718) 332-0077
Mailing address
105 KINGS HWY APT 5C, BROOKLYN, NY 11214-1562
(917) 907-3203
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
009805-1
NY
Other
Enumeration date
03/02/2012
Last updated
03/02/2012
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