Provider Demographics
NPI:1275508798
Name:ZALKIN, IRENE (MSW)
Entity Type:Individual
Prefix:
First Name:IRENE
Middle Name:
Last Name:ZALKIN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6526 RALSTON AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-1278
Mailing Address - Country:US
Mailing Address - Phone:317-251-2649
Mailing Address - Fax:317-255-5814
Practice Address - Street 1:6526 RALSTON AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-1278
Practice Address - Country:US
Practice Address - Phone:317-251-2649
Practice Address - Fax:317-255-5814
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN340005151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000201145Medicare UPIN
IN275320Medicare ID - Type UnspecifiedMEDICARE