MEDICARE: IRINA LEMPERT PA

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	363A00000X	Physician Assistant	009535	NY

General Provider Information

NPI Number	:	1336211028
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IRINA LEMPERT PA

Provider Business Mailing Address
First Line	:	986 WATEREDGE PL
Second Line	:
City	:	HEWLETT
State	:	NY
Zip	:	11557-2612
Country	:	US
Telephone Number	:	917-496-3100
Fax Number	:

Provider Business Practice Location Address
First Line	:	4813 9TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-2484
Country	:	US
Telephone Number	:	718-283-7979
Fax Number	:

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

Provider Enumeration Date	:	11/15/2006
Last Update Date	:	05/02/2024

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