Provider Demographics
NPI:1437661741
Name:IGNY MEDICAL PC
Entity Type:Organization
Organization Name:IGNY MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:IGOR
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHURAVENKO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:347-489-7777
Mailing Address - Street 1:197 BEACH 137TH ST
Mailing Address - Street 2:
Mailing Address - City:ROCKAWAY PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11694
Mailing Address - Country:US
Mailing Address - Phone:347-489-7777
Mailing Address - Fax:
Practice Address - Street 1:3048 BRIGHTON 1ST ST # 6B
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-8080
Practice Address - Country:US
Practice Address - Phone:718-945-4545
Practice Address - Fax:347-702-9545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-26
Last Update Date:2020-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY210937207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty