Provider Demographics
NPI:1356897102
Name:ST.FIRMIN, IRENE (LPN)
Entity type:Individual
Prefix:
First Name:IRENE
Middle Name:
Last Name:ST.FIRMIN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 WEST 148TH STREET
Mailing Address - Street 2:APT 51
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10031-3734
Mailing Address - Country:US
Mailing Address - Phone:929-227-0117
Mailing Address - Fax:
Practice Address - Street 1:2678 KINGSBRIDGE TER
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-7471
Practice Address - Country:US
Practice Address - Phone:718-796-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY296261164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse