Basic Information
| Provider Information | |||||||||
| NPI: | 1326163072 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | IRINEO | ||||||||
| FirstName: | NENA | ||||||||
| MiddleName: | ANDAL | ||||||||
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| Credential: | M .D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3 WATERMILL RD | ||||||||
| Address2: | |||||||||
| City: | CHESTNUT RIDGE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 109776528 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8456248974 | ||||||||
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| Practice Location | |||||||||
| Address1: | 45 ASHLEY DR. | ||||||||
| Address2: | |||||||||
| City: | MIDDLETOWN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10940 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8453436686 | ||||||||
| FaxNumber: | 8453268157 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/20/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 132144 | NY | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.