MEDICARE: IRYNA VASYLYEVA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	F358865-01	NY

General Provider Information

NPI Number	:	1225982333
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IRYNA VASYLYEVA

Provider Business Mailing Address
First Line	:	172 COLFAX AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-3361
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	172 COLFAX AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-3361
Country	:	US
Telephone Number	:	646-270-3078
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/25/2026
Last Update Date	:	04/17/2026

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Directions to “ IRYNA VASYLYEVA ” Practice Location

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