Provider Demographics
NPI:1588039846
Name:KREMEN, INNA (PA)
Entity Type:Individual
Prefix:MRS
First Name:INNA
Middle Name:
Last Name:KREMEN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2829 OCEAN PKWY STE 3
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-7859
Mailing Address - Country:US
Mailing Address - Phone:718-743-5300
Mailing Address - Fax:718-743-9540
Practice Address - Street 1:2829 OCEAN PKWY STE 3
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-7859
Practice Address - Country:US
Practice Address - Phone:718-743-5300
Practice Address - Fax:718-743-9540
Is Sole Proprietor?:No
Enumeration Date:2015-12-11
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013254363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical