Provider Demographics
NPI:1245411354
Name:MIKHEYEVA, IRINA (DO)
Entity type:Individual
Prefix:
First Name:IRINA
Middle Name:
Last Name:MIKHEYEVA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 CROPSEY AVE
Mailing Address - Street 2:APT D1
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-6800
Mailing Address - Country:US
Mailing Address - Phone:718-907-0195
Mailing Address - Fax:718-907-0195
Practice Address - Street 1:2148 OCEAN AVE STE 402
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1487
Practice Address - Country:US
Practice Address - Phone:718-975-7533
Practice Address - Fax:718-975-7530
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-16
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY254486207V00000X, 207VG0400X, 207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics