Provider Demographics
NPI:1033427059
Name:INOYATOVA, IRINA (PA)
Entity Type:Individual
Prefix:MS
First Name:IRINA
Middle Name:
Last Name:INOYATOVA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6441 SAUNDERS ST APT 506
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-3226
Mailing Address - Country:US
Mailing Address - Phone:718-896-5359
Mailing Address - Fax:
Practice Address - Street 1:6441 SAUNDERS ST APT 506
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-3226
Practice Address - Country:US
Practice Address - Phone:718-896-5359
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-24
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014156363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical