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NPI Code Detail

MEDICARE: IRYNA LAUTSEVICH

MEDICARE: IRYNA LAUTSEVICH
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
1363L00000XNurse PractitionerSP024307PA

General Provider Information

NPI Number : 1326722042
Entity Type Code : Individual
Provider Name (Legal Business Name) : IRYNA LAUTSEVICH
Provider Business Mailing Address
First Line : 1104 WELSH RD
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19115-3730
Country : US
Telephone Number : 216-676-9191
Fax Number :
Provider Business Practice Location Address
First Line : 1104 WELSH RD
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19115-3730
Country : US
Telephone Number : 215-676-9191
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2023
Last Update Date : 01/14/2026

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Directions to “ IRYNA LAUTSEVICH ” Practice Location

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