Healthcare Provider Details

I. General information

NPI: 1073307146
Provider Name (Legal Business Name): IRENE SOPHIA HRYTSYUK APRN.CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2025
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6115 POWERS BLVD
PARMA OH
44129-5471
US

IV. Provider business mailing address

6115 POWERS BLVD
PARMA OH
44129-5471
US

V. Phone/Fax

Practice location:
  • Phone: 440-845-6400
  • Fax: 440-845-6835
Mailing address:
  • Phone: 440-845-6400
  • Fax: 440-845-6835

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.0039019
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN.CNP.0039019
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: