Individual
MIKHAIL ILYABAYEV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1414 E 12TH ST, 3A, BROOKLYN, NY 11230-6659
(917) 576-2900
Mailing address
1414 E 12TH ST, 3A, BROOKLYN, NY 11230-6659
(917) 576-2900
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
033604
NY
Other
Enumeration date
05/20/2011
Last updated
05/20/2011
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