Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0210X | Pediatric Nephrologist | 225785 | NY |
Y | 2080P0210X | Pediatric Nephrologist | OS10700 | FL |
NPI | 1629094735 |
---|---|
Provider Name | Irina F Gershin-Stevens |
First Address | Fort Myers, FL 33902-2147 |
Second Address | Fort Myers, FL 33908-3838 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 25/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001529200 | (05) | FL |
02798516 | (05) | NY |
I63478 | (02) | NY |