Provider Demographics
NPI:1811673775
Name:NAYSHLOS, IRINA
Entity type:Individual
Prefix:
First Name:IRINA
Middle Name:
Last Name:NAYSHLOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 VOORHIES AVE APT 14B
Mailing Address - Street 2:
Mailing Address - City:BROOKYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235
Mailing Address - Country:US
Mailing Address - Phone:718-938-3696
Mailing Address - Fax:
Practice Address - Street 1:1501 VOORHIES AVE APT 14B
Practice Address - Street 2:
Practice Address - City:BROOKYN
Practice Address - State:NY
Practice Address - Zip Code:11235
Practice Address - Country:US
Practice Address - Phone:718-938-3696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY623413163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse