| Doctor Name: | IRINA GUTSALYUK |
| NPI Number: | 1073522942 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA |
| License Number: | 009810-1 |
| Business Practice Address: | 3931 Louisana Ave. S. St. Louis Park, MN - 55426 |
| Business Phone Number: | 9529932079 |
| Business Fax Number: | 7168875045 |
| Mailing Address: | 3931 Louisana Ave. S., ST. LOUIS PARK |
| State: | MN |
| Postal Code: | 55426 |
| Phone Number: | 9529932079 |
| Fax Number: | 7168875045 |
| NPI Enumeration Date: | 08/07/2006 |
| NPI Last Update Date: | 11/16/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | 009810-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |