Provider Demographics
NPI:1992092589
Name:STRINKOVSKAYA, IRINA (RPH)
Entity type:Individual
Prefix:
First Name:IRINA
Middle Name:
Last Name:STRINKOVSKAYA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 DITMAS AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-4902
Mailing Address - Country:US
Mailing Address - Phone:718-431-8232
Mailing Address - Fax:718-431-8253
Practice Address - Street 1:128 DITMAS AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-4902
Practice Address - Country:US
Practice Address - Phone:718-431-8232
Practice Address - Fax:718-431-8253
Is Sole Proprietor?:No
Enumeration Date:2011-07-01
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045181183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02556536Medicaid
5160580001Medicare PIN