Individual
DR. EKAMBARAM ILAMATHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
38 S WINDSOR AVE, BRIGHTWATERS, NY 11718-1505
(516) 318-8527
Mailing address
38 S WINDSOR AVE, BRIGHTWATERS, NY 11718-1505
(516) 318-8527
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
126913
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00384827
—
NY
01
—
1318
VYTRA
NY
01
—
337741
EMPIRE BLUECROSS BLUSHIEL
NY
01
—
390001418
MEDICARE RAILROAD
NY
01
—
CS665
OXFORD
NY
Enumeration date
07/11/2005
Last updated
07/12/2023
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