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1073005484
IRYNA ILYASOVA
PORT JEFFERSON STATION, NY
NPI
1073005484
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: NY 311503)
Enumeration Date
2018-05-31
Last Update Date
2021-07-20
Business Address
Dr. IRYNA ILYASOVA M.D
1500 ROUTE 112 STE A
PORT JEFFERSON STATION, NY 11776-8055
Phone number: 631-686-1414
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Mailing Address
Dr. IRYNA ILYASOVA M.D
1500 ROUTE 112 STE A
PORT JEFFERSON STATION, NY 11776-8055
Phone number: 631-743-6840
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