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Individual
DR. DENNIS ILITCHEV
Active
Individual
DR. DENNIS ILITCHEV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
063596
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
063596
PHARMACIST LICENSE
NY
01
—
092008
INTERN PERMIT
NY
Enumeration date
10/12/2017
Last updated
10/12/2017
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