Provider Demographics
NPI:1083503486
Name:ARTYMOVYCH, IRYNA (FNP)
Entity type:Individual
Prefix:
First Name:IRYNA
Middle Name:
Last Name:ARTYMOVYCH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4628 CEDARVALE RD
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13215-8770
Mailing Address - Country:US
Mailing Address - Phone:315-383-9387
Mailing Address - Fax:
Practice Address - Street 1:28 1/2 E MAIN ST STE 1
Practice Address - Street 2:
Practice Address - City:MARCELLUS
Practice Address - State:NY
Practice Address - Zip Code:13108-1280
Practice Address - Country:US
Practice Address - Phone:315-673-9926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY356931207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty