Provider Demographics
NPI:1790929107
Name:DECTER, IRINA (MD)
Entity Type:Individual
Prefix:DR
First Name:IRINA
Middle Name:
Last Name:DECTER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:575 LEXINGTON AVE STE 500
Mailing Address - Street 2:NEWYORK-PRESBYTERIAN/WEILL CORNELL MEDICAL COLLEGE
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-6102
Mailing Address - Country:US
Mailing Address - Phone:212-746-6000
Mailing Address - Fax:646-962-0122
Practice Address - Street 1:525 E. 68TH STREET, BOX 141
Practice Address - Street 2:NEWYORK-PRESBYTERIAN/WEILL CORNELL MEDICAL COLLEGE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-4885
Practice Address - Country:US
Practice Address - Phone:212-746-6000
Practice Address - Fax:646-962-0122
Is Sole Proprietor?:No
Enumeration Date:2009-04-29
Last Update Date:2014-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY2736272085R0202X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program