Individual
DMITRY ILYEVSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
369 93RD ST, BROOKLYN, NY 11209-6901
(718) 680-6000
(718) 680-3682
Mailing address
369 93RD ST, BROOKLYN, NY 11209-6901
(718) 680-6000
(718) 680-3682
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
260048
NY
208000000X
Pediatrics Physician
260048
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03375275
—
NY
Enumeration date
01/29/2007
Last updated
11/29/2011
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