Provider Demographics
NPI:1235753013
Name:PADIN, IRENE C (PHD, CLINICAL THAN)
Entity Type:Individual
Prefix:MRS
First Name:IRENE
Middle Name:C
Last Name:PADIN
Suffix:
Gender:F
Credentials:PHD, CLINICAL THAN
Other - Prefix:
Other - First Name:IRENE
Other - Middle Name:C
Other - Last Name:PADIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:THANATOLOGIST, PHD
Mailing Address - Street 1:48 AVENIDA LUIS MUNOZ RIVERA
Mailing Address - Street 2:PLAZA LEONARDO AVILES
Mailing Address - City:CAMUY
Mailing Address - State:PR
Mailing Address - Zip Code:00627
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:48 AVENIDA LUIS MUNOZ RIVERA
Practice Address - Street 2:CENTRO PLAZA LEONARDO AVILES
Practice Address - City:CAMUY
Practice Address - State:PR
Practice Address - Zip Code:00627
Practice Address - Country:US
Practice Address - Phone:939-599-1041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-08
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
THANATOLOGY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty