Individual
IRINA ILYAYEVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3703 92ND ST FL 1, JACKSON HEIGHTS, NY 11372-7929
(917) 832-6562
(646) 930-5556
Mailing address
3703 92ND ST FL 1, JACKSON HEIGHTS, NY 11372-7929
(917) 832-6562
(646) 930-5556
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
237803
NY
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
237803
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02710218
—
NY
Enumeration date
07/07/2006
Last updated
09/28/2023
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