Provider Demographics
NPI:1083247837
Name:IRINA'S KIDS CORP
Entity Type:Organization
Organization Name:IRINA'S KIDS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRIMAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-353-8264
Mailing Address - Street 1:30 PIERPONT PL
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-5955
Mailing Address - Country:US
Mailing Address - Phone:917-353-8264
Mailing Address - Fax:
Practice Address - Street 1:30 PIERPONT PL
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-5955
Practice Address - Country:US
Practice Address - Phone:917-353-8264
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-20
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency