Provider Demographics
NPI:1164019154
Name:KLEIN, IRYNA (PHARMD)
Entity Type:Individual
Prefix:
First Name:IRYNA
Middle Name:
Last Name:KLEIN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:IRYNA
Other - Middle Name:
Other - Last Name:KOVALENKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5053 HWY 70 W
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-4503
Mailing Address - Country:US
Mailing Address - Phone:252-222-0288
Mailing Address - Fax:252-222-3626
Practice Address - Street 1:5053 HWY 70 W
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-4503
Practice Address - Country:US
Practice Address - Phone:651-414-3882
Practice Address - Fax:651-414-3888
Is Sole Proprietor?:No
Enumeration Date:2020-12-24
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN124992183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist