# ATLANTIC ENDOCRINOLOGY AND DIABETES PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407059199
- **Authorized official:** STELLA ILYAYEVA MD (MD)
- **Authorized official phone:** (718) 275-2900

## Contact information

- **Practice address:** 9725 63RD DR, REGO PARK, NY 11374-2229
- **Practice address phone:** (718) 275-2900
- **Practice address fax:** (718) 275-2944
- **Mailing address:** 9725 63RD DR, REGO PARK, NY 11374-2229
- **Mailing address phone:** (718) 275-2900
- **Mailing address fax:** (718) 275-2944

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207K00000X | Allergy & Immunology Physician | — | — | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | Yes |
| 207RN0300X | Nephrology Physician | — | — | — |
| 2084N0400X | Neurology Physician | — | — | — |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | — | — |
| 213E00000X | Podiatrist | — | — | — |
| 225100000X | Physical Therapist | — | — | — |

## Other

- **Enumeration date:** 06/08/2007
- **Last updated:** 02/18/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 02148396 | — | NY |
| 05 | — | 03436793 | — | NY |