Provider Demographics
NPI:1992596407
Name:FORIN, IRENE (FNP)
Entity type:Individual
Prefix:
First Name:IRENE
Middle Name:
Last Name:FORIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:635 AVENUE Y
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-6124
Mailing Address - Country:US
Mailing Address - Phone:347-607-9879
Mailing Address - Fax:
Practice Address - Street 1:2952 BRIGHTON 3RD ST STE 401
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-7079
Practice Address - Country:US
Practice Address - Phone:718-975-3833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY348136363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily