Provider Demographics
NPI:1962400747
Name:MAGRAMM, IRENE (MD)
Entity type:Individual
Prefix:DR
First Name:IRENE
Middle Name:
Last Name:MAGRAMM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 E 63RD ST
Mailing Address - Street 2:APT. 1207
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-7466
Mailing Address - Country:US
Mailing Address - Phone:212-308-7366
Mailing Address - Fax:
Practice Address - Street 1:225 E 64TH ST
Practice Address - Street 2:SUITE 6
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-6690
Practice Address - Country:US
Practice Address - Phone:212-644-5100
Practice Address - Fax:212-644-2520
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY153878207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00905904Medicaid
NYDS711OtherOXFORD
NY0029205OtherGHI
NYMCA036801OtherAMERICHOICE
NYOC3248OtherHEALTHNET
NY53702POtherHIP
NYMCA036801OtherAMERICHOICE
NYOC3248OtherHEALTHNET