Provider Demographics
NPI:1255689089
Name:GLUZMAN, IRINA
Entity Type:Individual
Prefix:
First Name:IRINA
Middle Name:
Last Name:GLUZMAN
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 1:21 HERITAGE DR
Mailing Address - Street 2:APT. A
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-5334
Mailing Address - Country:US
Mailing Address - Phone:212-464-7696
Mailing Address - Fax:
Practice Address - Street 1:21 HERITAGE DR
Practice Address - Street 2:APT. A
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-5334
Practice Address - Country:US
Practice Address - Phone:212-464-7696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-28
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist