Provider Demographics
NPI:1285823559
Name:MILGRAM, IRINA (PA)
Entity Type:Individual
Prefix:MS
First Name:IRINA
Middle Name:
Last Name:MILGRAM
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:87 BRUNSWICK WOODS DR
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-5601
Mailing Address - Country:US
Mailing Address - Phone:732-254-0081
Mailing Address - Fax:732-254-2851
Practice Address - Street 1:561 CRANBURY RD
Practice Address - Street 2:SUITE L
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-5400
Practice Address - Country:US
Practice Address - Phone:732-390-1883
Practice Address - Fax:732-907-1711
Is Sole Proprietor?:No
Enumeration Date:2007-10-23
Last Update Date:2009-12-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MP00189100363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical