Provider Demographics
NPI:1659316826
Name:SHPAK, IRINA V (MD)
Entity Type:Individual
Prefix:DR
First Name:IRINA
Middle Name:V
Last Name:SHPAK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4271 HEMPSTEAD TPKE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11714
Mailing Address - Country:US
Mailing Address - Phone:516-796-3700
Mailing Address - Fax:516-796-3205
Practice Address - Street 1:4271 HEMPSTEAD TPKE
Practice Address - Street 2:SUITE 1
Practice Address - City:BETHPAGE
Practice Address - State:NY
Practice Address - Zip Code:11714
Practice Address - Country:US
Practice Address - Phone:516-796-3700
Practice Address - Fax:516-796-3205
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2146821207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02288948Medicaid
H75125Medicare UPIN
NY02288948Medicaid