Provider Demographics
NPI:1558947168
Name:KIREINA MEDICAL PLLC
Entity Type:Organization
Organization Name:KIREINA MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LYNNEA
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLANOVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-756-2312
Mailing Address - Street 1:140 BERKELEY PL
Mailing Address - Street 2:#1
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217
Mailing Address - Country:US
Mailing Address - Phone:917-756-2312
Mailing Address - Fax:
Practice Address - Street 1:116 CHAMBERS ST FL 4
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10007-1075
Practice Address - Country:US
Practice Address - Phone:917-756-2312
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-23
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center