Organization
ISLAND OF HEALTH MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ILYA KLEYN (MD)
(917) 554-5735
Entity
Organization
Contact information
Practice address
8002 165 ST. UNION TNPK., JAMAICA, NY 11432
(718) 380-7000
(212) 571-5001
Mailing address
80-02 165 ST. UNION TNPK., JAMAICA, NY 11432
(718) 380-7000
(212) 571-5001
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
215006
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02091596
—
NY
Enumeration date
10/12/2006
Last updated
04/08/2008
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