Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | 35-07-7122K | OH |
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 54205 | KY |
NPI | 1093793994 |
---|---|
Provider Name | Irina Korableva |
First Address | Cincinnati, OH 45263-5283 |
Second Address | Covington, KY 41011-0801 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2006 |
Last Update Date | 08/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2137084 | (05) | OH |
H02589 | (02) | OH |