Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | N006323-1 | NY |
NPI | 1376771170 |
---|---|
Provider Name | Dr. Irina Pechalidi |
First Address | Brooklyn, NY 11223-6150 |
Second Address | Brooklyn, NY 11223-6150 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2009 |
Last Update Date | 30/06/2009 |