MEDICARE: IRINA POWERS MEDICAL PLLC

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	207RG0300X	Geriatric Medicine (Internal Medicine) Physician

General Provider Information

NPI Number	:	1396259826
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IRINA POWERS MEDICAL PLLC

Provider Business Mailing Address
First Line	:	1562 1ST AVE # 308
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10028-4004
Country	:	US
Telephone Number	:	347-248-1771
Fax Number	:

Provider Business Practice Location Address
First Line	:	1562 1ST AVE # 308
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10028-4004
Country	:	US
Telephone Number	:	347-248-1771
Fax Number	:

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. IRINA POWERS
Credential	:	DO
Telephone Number	:	347-248-1771

Provider Enumeration Date	:	11/20/2017
Last Update Date	:	11/20/2017

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