Individual
DR. ILYA TARASCIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
161 HEMPSTEAD TPKE, ELMONT, NY 11003-1432
(516) 571-8200
(516) 571-8221
Mailing address
1600 STEWART AVENUE, SUITE 300, LONG ISLAND FQHC, INC., WESTBURY, NY 11590
(516) 571-8200
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
269210
NY
Other
Enumeration date
07/08/2010
Last updated
03/23/2020
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