1346408739 NPI number — MS. IRINA V. ZENKOVA CRNA

Table of content: MS. IRINA V. ZENKOVA CRNA (NPI 1346408739)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346408739 NPI number — MS. IRINA V. ZENKOVA CRNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZENKOVA
Provider First Name:
IRINA
Provider Middle Name:
V.
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
CRNA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346408739
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/02/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2 CATHARINE STREET P.O. BOX 550
Provider Second Line Business Mailing Address:
PARK SLOPE ANESTHESIA ASSOCIATES, PC
Provider Business Mailing Address City Name:
POUGHKEEPSIE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12602
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
866-808-8416
Provider Business Mailing Address Fax Number:
845-790-2675

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
506 6TH STREET
Provider Second Line Business Practice Location Address:
NY METHODIST HOSPITAL
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11215
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-780-3279
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/02/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 367500000X , with the licence number:  497977-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 367500000X , with the licence number: RN592891 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: A400010755 . This is a "MEDICARE PTAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: RN592891 . This is a "LICENSE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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