MEDICARE: IRYNN AND ASSOCIATES

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	261QH0100X	Health Service Clinic/Center	MD065794L	PA

General Provider Information

NPI Number	:	1912345661
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IRYNN AND ASSOCIATES

Provider Business Mailing Address
First Line	:	PO BOX 14397
Second Line	:
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44514
Country	:	US
Telephone Number	:	330-758-2775
Fax Number	:	330-758-2787

Provider Business Practice Location Address
First Line	:	3548 ELLWOOD RD
Second Line	:
City	:	NEW CASTLE
State	:	PA
Zip	:	16101-6122
Country	:	US
Telephone Number	:	412-719-5541
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. MOHAMMED FAKHRUL ISLAM
Credential	:	MD
Telephone Number	:	412-719-5541

Provider Enumeration Date	:	06/04/2013
Last Update Date	:	06/19/2013

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