Individual
DR. IRYNA ILYASOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
75 N COUNTRY RD, PORT JEFFERSON, NY 11777-2119
(631) 473-1320
Mailing address
75 N COUNTRY RD, PORT JEFFERSON, NY 11777-2119
(631) 473-1320
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
311503
NY
208M00000X
Hospitalist Physician
Primary
311503
NY
Other
Enumeration date
05/31/2018
Last updated
11/03/2025
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