Provider Demographics
NPI:1942382718
Name:KAPLAN, IRINA INNA (MD)
Entity Type:Individual
Prefix:DR
First Name:IRINA
Middle Name:INNA
Last Name:KAPLAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 14890
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12212-4890
Mailing Address - Country:US
Mailing Address - Phone:518-525-5634
Mailing Address - Fax:518-649-4094
Practice Address - Street 1:158 SARATOGA AVE
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:NY
Practice Address - Zip Code:12188-2205
Practice Address - Country:US
Practice Address - Phone:518-233-1162
Practice Address - Fax:518-233-0903
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY214690207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01976952Medicaid
NYRA2538Medicare PIN