Provider Demographics
NPI:1902210735
Name:PRIMAK, IRINA (MS ED)
Entity Type:Individual
Prefix:
First Name:IRINA
Middle Name:
Last Name:PRIMAK
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1852 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-2638
Mailing Address - Country:US
Mailing Address - Phone:917-353-8264
Mailing Address - Fax:
Practice Address - Street 1:1852 W 5TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-2638
Practice Address - Country:US
Practice Address - Phone:917-353-8264
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-19
Last Update Date:2014-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist