MEDICARE: DR. IRINA N FUCHS D.O.

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	207Q00000X	Family Medicine Physician	223524-1	NY

Other Identifiers

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

General Provider Information

NPI Number	:	1568466977
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. IRINA N FUCHS D.O.

Provider Business Mailing Address
First Line	:	7620 BAY PKWY
Second Line	:	STE 1C
City	:	BROOKLYN
State	:	NY
Zip	:	11214-1534
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7620 BAY PKWY
Second Line	:	STE 1C
City	:	BROOKLYN
State	:	NY
Zip	:	11214-1534
Country	:	US
Telephone Number	:	718-234-9100
Fax Number	:	718-234-0240

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

Provider Enumeration Date	:	06/13/2005
Last Update Date	:	05/14/2020

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