Provider Demographics
NPI:1932816378
Name:KUROCHKA, IRYNA
Entity Type:Individual
Prefix:
First Name:IRYNA
Middle Name:
Last Name:KUROCHKA
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 1:5230 CENTRE AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15232-1304
Mailing Address - Country:US
Mailing Address - Phone:412-623-2287
Mailing Address - Fax:
Practice Address - Street 1:5230 CENTRE AVE FL 2
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232-1304
Practice Address - Country:US
Practice Address - Phone:412-623-2287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-04
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0002X
VA0202220900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No3336C0002XSuppliersPharmacyClinic Pharmacy