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General NPI Number Information
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NPI Number | 1093901217
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Entity Type | Individual
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Provider Name | IRINI A SEDRAK MD
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Gender | Female
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Dates
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Enumeration Date | 09/20/2007
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Last Update Date | 07/31/2009
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Provider Practice Location Address
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Address Line | 2800 MARCUS AVENUE
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City | NEW HYDE PARK
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State | NY
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Zip | 11042
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Country | US
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Telephone | 516-622-7405
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Fax |
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Provider Business Mailing Address
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Address Line | 61 73 69TH LANE MIDDLE VILLAGE
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City | MIDDLE VILLAGE
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State | NY
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Zip | 11379
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Country | US
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Telephone | 347-613-4674
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Fax | 347-613-4674
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 002842
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License Number State | NY
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