Search › Georgia › 363AS0400X
Irina Sidorenko
NPI 1740898279 · on the registry since 2020
Practice
- Address
- 2311 Ridge Forest Dr
Grayson, GA 30017 - Phone
- (678) 656-6819
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 363AS0400X
363AS0400X
- Also registered as
- 208600000X
- Licence states on file
- GA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2021-11-19
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia