| Irina Medical P.c. | |
|
474 Ovington Ave Brooklyn NY 11209-1550 | |
| (718) 238-2625 | |
| (718) 238-2704 |
| Full Name | Irina Medical P.c. |
|---|---|
| Speciality | General Practice |
| Location | 474 Ovington Ave, Brooklyn, New York |
| Authorized Official Name and Position | Irina Koukharenko (OWNER) |
| Authorized Official Contact | 7182382625 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Irina Medical P.c. 2952 Brighton 3rd St Ste 201 Brooklyn NY 11235-7078 Ph: (718) 975-4334 | Irina Medical P.c. 474 Ovington Ave Brooklyn NY 11209-1550 Ph: (718) 238-2625 |
| NPI Number | 1609008119 |
|---|---|
| Provider Enumeration Date | 08/17/2009 |
| Last Update Date | 11/23/2020 |
| Medicare PECOS PAC ID | 9638216484 |
|---|---|
| Medicare Enrollment ID | O20091027000516 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609008119 | NPI | - | NPPES |
| 02634619 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 232682 (New York) | Primary |
| Provider Name | Irina Koukharenko |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093768681 PECOS PAC ID: 1850355462 Enrollment ID: I20041115000140 |
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