Provider Demographics
NPI:1225451602
Name:BLUVSHTEYN, IRINA
Entity Type:Individual
Prefix:
First Name:IRINA
Middle Name:
Last Name:BLUVSHTEYN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1773 E 12TH ST
Mailing Address - Street 2:APT # 1J
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1051
Mailing Address - Country:US
Mailing Address - Phone:646-460-1408
Mailing Address - Fax:
Practice Address - Street 1:1773 E 12TH ST
Practice Address - Street 2:APT# 1J
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1051
Practice Address - Country:US
Practice Address - Phone:646-460-1408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-21
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist