Individual
DR. SVETLANA ILIZAROV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
181 BELLE MEAD RD, EAST SETAUKET, NY 11733-3495
(631) 444-6996
Mailing address
HSC 18 ROOM 020 DEPARTMENT OF ORTHOPAEDICS, STONY BROOK UNIVERSITY MEDICAL CENTER, STONY BROOK, NY 11794-0001
(631) 444-6996
(631) 444-7671
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
215268
NY
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
215268
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2090022
—
NY
Enumeration date
08/01/2006
Last updated
07/27/2008
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