Individual
DR. IGOR ILYABAYEV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
139 N CENTRAL AVE, SUITE #3, VALLEY STREAM, NY 11580-3856
(516) 887-0020
(516) 887-0080
Mailing address
139 N CENTRAL AVE, SUITE#3, VALLEY STREAM, NY 11580-3856
(516) 887-0020
(516) 887-0080
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
052814
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03168361
—
NY
Enumeration date
03/15/2008
Last updated
10/31/2015
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