Provider Demographics
NPI:1992982599
Name:ROSKINA, IRINA
Entity type:Individual
Prefix:
First Name:IRINA
Middle Name:
Last Name:ROSKINA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 3RD AVE
Mailing Address - Street 2:CVS PHARMACY
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-5501
Mailing Address - Country:US
Mailing Address - Phone:212-677-4677
Mailing Address - Fax:212-677-6972
Practice Address - Street 1:275 3RD AVE
Practice Address - Street 2:CVS PHARMACY
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-5501
Practice Address - Country:US
Practice Address - Phone:212-677-4677
Practice Address - Fax:212-677-6972
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-25
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043377183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist