IRINA SIDORENKO NPI 1740898279

NPI Information

NPI: 1740898279
Provider Name: IRINA SIDORENKO
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

Address:
2311 RIDGE FOREST DR
GRAYSON, GA
ZIP 30017
Phone: (678) 656-6819
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Irina Sidorenko is a surgical physician assistant in Grayson, GA. Irina Sidorenko NPI is 1740898279. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2311 RIDGE FOREST DR
GRAYSON, GA
ZIP 30017-718
Phone: (678) 656-6819

The enumeration date for this NPI number is 7/21/2020 and was last updated on 11/19/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208600000X	Surgery		20299	GEORGIA	No
2	363AS0400X	Physician Assistant	Surgical	20-299	GEORGIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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