Individual
DR. ILYA KISTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
240 E 38TH ST FL 13, NEW YORK, NY 10016-2708
(646) 501-7500
Mailing address
301 E 17TH ST, SUITE 544, NEW YORK, NY 10003-3804
(212) 598-6305
(212) 598-6214
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
241042
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02932543
—
NY
Enumeration date
04/02/2007
Last updated
08/15/2022
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