Individual
DR. EMMANUIL ILYAYEV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
9819 64TH AVE, 4G, REGO PARK, NY 11374-2542
(718) 578-8612
Mailing address
9819 64TH AVE, 4G, REGO PARK, NY 11374-2542
(718) 578-8612
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
058141
NY
1223G0001X
General Practice Dentistry
11338
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/23/2007
Last updated
03/07/2016
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