Provider Demographics
NPI:1396766010
Name:DONEV, IRINA I (MD)
Entity type:Individual
Prefix:DR
First Name:IRINA
Middle Name:I
Last Name:DONEV
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 MEMORIAL HIGHWAY
Mailing Address - Street 2:SUITE 1-5
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801
Mailing Address - Country:US
Mailing Address - Phone:914-636-1035
Mailing Address - Fax:914-636-1080
Practice Address - Street 1:175 MEMORIAL HIGHWAY
Practice Address - Street 2:SUITE 1-5
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801
Practice Address - Country:US
Practice Address - Phone:914-636-1035
Practice Address - Fax:914-636-1080
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY164504207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01028757Medicaid
NY46F243Medicare PIN
B83282Medicare UPIN