Provider Demographics
NPI:1972767747
Name:IRINA VILENSKAYA MD PC
Entity Type:Organization
Organization Name:IRINA VILENSKAYA MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:VILENSKAYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-222-1133
Mailing Address - Street 1:127 PAVILION AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07740-6415
Mailing Address - Country:US
Mailing Address - Phone:732-222-1133
Mailing Address - Fax:732-222-9345
Practice Address - Street 1:127 PAVILION AVE
Practice Address - Street 2:
Practice Address - City:LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07740-6415
Practice Address - Country:US
Practice Address - Phone:732-222-1133
Practice Address - Fax:732-222-9345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-10
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty