Provider Demographics
NPI:1568466977
Name:FUCHS, IRINA N (DO)
Entity Type:Individual
Prefix:DR
First Name:IRINA
Middle Name:N
Last Name:FUCHS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7620 BAY PKWY
Mailing Address - Street 2:STE 1C
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-1534
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7620 BAY PKWY
Practice Address - Street 2:STE 1C
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-1534
Practice Address - Country:US
Practice Address - Phone:718-234-9100
Practice Address - Fax:718-234-0240
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-13
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY223524-1207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02227796Medicaid
NY46V651Medicare ID - Type Unspecified
NYH62026Medicare UPIN