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NPI Code Detail

MEDICARE: DR. IRINA NELIPOVICH M.D.

MEDICARE: DR. IRINA NELIPOVICH M.D.
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
1208000000XPediatrics Physician210663NY

Other Identifiers

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

General Provider Information

NPI Number : 1033187174
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. IRINA NELIPOVICH M.D.
Provider Business Mailing Address
First Line : 2550 E 24TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11235-2515
Country : US
Telephone Number : 718-648-0218
Fax Number :
Provider Business Practice Location Address
First Line : 1761 E 12TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11229-1013
Country : US
Telephone Number : 718-336-1111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2006
Last Update Date : 07/08/2007

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