Healthcare Provider Details

I. General information

NPI: 1154559250
Provider Name (Legal Business Name): IRINA PLOTKINA RPA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2009
Last Update Date: 06/06/2025
Certification Date: 06/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ONE GUSTAVE L. LEVI PL
NEW YORK NY
10029
US

IV. Provider business mailing address

ONE GUSTAVE L. LEVI PL
NEW YORK NY
10029
US

V. Phone/Fax

Practice location:
  • Phone: 121-659-6800
  • Fax:
Mailing address:
  • Phone: 121-659-6800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number23 007709
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: