Basic Information
Provider Information
NPI: 1215371992
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LAPTEVSKY
FirstName: IRINA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 55 WATER ST
Address2: 2ND FLOOR CRED DEPT
City: NEW YORK
State: NY
PostalCode: 100410004
CountryCode: US
TelephoneNumber: 6466802888
FaxNumber: 5165425556
Practice Location
Address1: 3245 NOSTRAND AVE
Address2:  
City: BROOKLYN
State: NY
PostalCode: 11229
CountryCode: US
TelephoneNumber: 7186153777
FaxNumber: 7186153717
Other Information
ProviderEnumerationDate: 04/24/2013
LastUpdateDate: 09/16/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X284375NYY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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