Provider Demographics
NPI:1154537702
Name:HEPBURN, IRYNA SOPHIA (MD)
Entity type:Individual
Prefix:DR
First Name:IRYNA
Middle Name:SOPHIA
Last Name:HEPBURN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:IRYNA
Other - Middle Name:
Other - Last Name:BABENKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-376-1180
Mailing Address - Fax:717-273-6937
Practice Address - Street 1:954 ISABEL DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-7482
Practice Address - Country:US
Practice Address - Phone:717-376-1180
Practice Address - Fax:717-273-6937
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2018-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD445530207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1027225090001Medicaid
PA242225Medicare PIN