| NPI | 1811241631 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DMITRY ILYEVSKY President 718-220-0439 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 260048) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 260048) |
| Enumeration Date | 2012-10-31 |
| Last Update Date | 2012-10-31 |