Irina Tyutyunnikova

Key facts

NPI

1780968594

Entity type

Individual (NPI type 1)

Primary specialty

Driver 172A00000X

Practice address

862 Hendrix St.
Phila, PA 19116-2526

Phone

(215) 713-6262

NPI assigned

Sep 29, 2011

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 7, 2011.

{
    "created_epoch": "1317254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323216000000",
    "number": "1780968594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "862 HENDRIX ST.",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191162526",
            "telephone_number": "215-713-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "862 HENDRIX ST.",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191162526",
            "telephone_number": "215-713-6262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYUTYUNNIKOVA",
        "first_name": "IRINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-29",
        "last_updated": "2011-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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