Provider Demographics
NPI:1790811107
Name:ZHUKOVA, IRINA (DO)
Entity Type:Individual
Prefix:
First Name:IRINA
Middle Name:
Last Name:ZHUKOVA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 PARK AVENUE
Mailing Address - Street 2:
Mailing Address - City:EAST RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07073
Mailing Address - Country:US
Mailing Address - Phone:201-939-7161
Mailing Address - Fax:201-939-3377
Practice Address - Street 1:325 ROUTE 10
Practice Address - Street 2:
Practice Address - City:EAST HANOVER
Practice Address - State:NJ
Practice Address - Zip Code:07936
Practice Address - Country:US
Practice Address - Phone:973-386-1133
Practice Address - Fax:973-386-5522
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB08042400207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine