Provider Demographics
NPI:1710114954
Name:BELYKH-MIRER, IRINA (RN)
Entity Type:Individual
Prefix:MRS
First Name:IRINA
Middle Name:
Last Name:BELYKH-MIRER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 NORTHERN PKWY W
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-1933
Mailing Address - Country:US
Mailing Address - Phone:718-683-2214
Mailing Address - Fax:516-941-0735
Practice Address - Street 1:142 NORTHERN PKWY W
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-1933
Practice Address - Country:US
Practice Address - Phone:718-683-2214
Practice Address - Fax:516-941-0735
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-15
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY485732163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health