Provider Demographics
NPI:1821336090
Name:STEPANYAN, IRINA (MS)
Entity Type:Individual
Prefix:MRS
First Name:IRINA
Middle Name:
Last Name:STEPANYAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2126 BENSON AVE APT 3A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-5031
Mailing Address - Country:US
Mailing Address - Phone:347-421-2724
Mailing Address - Fax:
Practice Address - Street 1:2260 BENSON AVE APT 3K
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-5235
Practice Address - Country:US
Practice Address - Phone:347-421-2724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-23
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist