Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ianina Suponitsky, AGNP

Individual provider Adult Health Nurse Practitioner · NPI 1124407465

Ianina Suponitsky, AGNP is a Nurse Practitioner in Brooklyn, New York. Qualified in 2018, 8 years ago. Practices with Interborough Developmental and Consultation Center Inc, a 152-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
8
Licensed in
NY
In the registry since
2015
What do these letters mean?
AGNP — Adult-Gerontology Nurse Practitioner
A nurse practitioner focused on adults and older people.

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Practice location Address checks out

1773 E 12th St #4D
Brooklyn, NY 11229-1051
Phone: (347) 713-3023
Fax: (718) 208-4022
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence F307084-1 (NY)

Record details

NPI number1124407465
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGNP
Sole proprietorYes
NPI enumeratedMay 19, 2015
Last updated in NPPESSeptember 22, 2020
Certification dateSeptember 22, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Interborough Developmental And Consultation Center Inc — 152 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

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