Provider Demographics
NPI:1609129774
Name:IRIZARRY, MARIA M III (RN)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:M
Last Name:IRIZARRY
Suffix:III
Gender:F
Credentials:RN
Other - Prefix:PROF
Other - First Name:MARIA
Other - Middle Name:M
Other - Last Name:IRIZARRY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:8201 4TH AVE APT 1G
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-4429
Mailing Address - Country:US
Mailing Address - Phone:718-491-4708
Mailing Address - Fax:
Practice Address - Street 1:8201 4TH AVE APT 1G
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-4429
Practice Address - Country:US
Practice Address - Phone:718-491-4708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-26
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY487752163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse