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General NPI Number Information
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NPI Number | 1942114012
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Entity Type | Organization
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Legal Business Name | IR PHYSICIAN SERVICES, PA
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Dates
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Enumeration Date | 09/28/2026
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Last Update Date | 09/28/2026
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Provider Practice Location Address
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Address Line | 3330 MASONIC DR
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City | ALEXANDRIA
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State | LA
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Zip | 71301-3841
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Country | US
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Telephone | 718-787-5559
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Fax | 718-603-9469
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Provider Business Mailing Address
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Address Line | 117 W CENTRAL BLVD UNIT 16
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City | PALISADES PARK
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State | NJ
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Zip | 07650-5002
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Country | US
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Telephone | 718-787-5559
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Fax | 718-603-9469
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Authorized Official
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Title or Position | OWNER
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Name | SERGEI SOBOLEVSKY
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Credential | MD
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Telephone | 646-267-3432
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State | NULL
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