MEDICARE: MS. IRINA VOSKOBOYNIK LCSW

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	1041C0700X	Clinical Social Worker	069657	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457371783
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. IRINA VOSKOBOYNIK LCSW

Provider Business Mailing Address
First Line	:	202 FOSTER AVE
Second Line	:	SUITE A
City	:	BROOKLYN
State	:	NY
Zip	:	11230-2119
Country	:	US
Telephone Number	:	718-854-3005
Fax Number	:	718-854-9803

Provider Business Practice Location Address
First Line	:	202 FOSTER AVE
Second Line	:	SUITE A
City	:	BROOKLYN
State	:	NY
Zip	:	11230-2119
Country	:	US
Telephone Number	:	718-854-3005
Fax Number	:	718-854-9803

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

Provider Enumeration Date	:	07/20/2006
Last Update Date	:	07/08/2007

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