Provider Demographics
NPI:1699007815
Name:BABOSHKINA, IRINA (PHARMD)
Entity Type:Individual
Prefix:MISS
First Name:IRINA
Middle Name:
Last Name:BABOSHKINA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 BISHOP ST
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-2145
Mailing Address - Country:US
Mailing Address - Phone:718-809-9437
Mailing Address - Fax:718-979-1072
Practice Address - Street 1:1361 HYLAN BLVD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-1902
Practice Address - Country:US
Practice Address - Phone:718-979-2828
Practice Address - Fax:718-979-1072
Is Sole Proprietor?:No
Enumeration Date:2010-02-12
Last Update Date:2010-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050710-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist