MEDICARE: DR. IRENE PARASKEVAKIS 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
1	207R00000X	Internal Medicine Physician	272074	NY
2	207R00000X	Internal Medicine Physician	052101	CT

General Provider Information

NPI Number	:	1043444086
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. IRENE PARASKEVAKIS M.D.

Provider Business Mailing Address
First Line	:	186 JORALEMON ST FL 11
Second Line	:	WEILL CORNELL MEDICAL COLLEGE
City	:	BROOKLYN
State	:	NY
Zip	:	11201-4356
Country	:	US
Telephone Number	:	646-962-4600
Fax Number	:	718-852-7007

Provider Business Practice Location Address
First Line	:	186 JORALEMON ST FL 11
Second Line	:	WEILL CORNELL MEDICAL COLLEGE
City	:	BROOKLYN
State	:	NY
Zip	:	11201-4356
Country	:	US
Telephone Number	:	646-962-4600
Fax Number	:	718-852-7007

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2009
Last Update Date	:	05/12/2014

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