Active NPI
Irina Kolos, M.D.
- Psychiatry Physician
- Lebanon, PA
National Provider Identifier
1669819884
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MD466205
- Practice address
- 1700 S Lincoln Ave
Lebanon, PA 17042-7529 - Phone
- (717) 272-6621
- NPI assigned
- May 29, 2013
- Last updated
- Jan 22, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | MD466205 | PA | Primary |
Addresses
Primary practice location
1700 S Lincoln Ave
Lebanon, PA 17042-7529
Mailing address
690 Stoverdale Rd
Hummelstown, PA 17036-8863
Phone (347) 374-0712
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD466205 | PA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548115200000",
"number": "1669819884",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "690 STOVERDALE RD",
"city": "HUMMELSTOWN",
"state": "PA",
"postal_code": "170368863",
"telephone_number": "347-374-0712"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 S LINCOLN AVE",
"city": "LEBANON",
"state": "PA",
"postal_code": "170427529",
"telephone_number": "717-272-6621"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOLOS",
"first_name": "IRINA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-05-29",
"last_updated": "2019-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "PA",
"license": "MD466205",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lebanon, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.