Individual
DR. STANISLAV V ILYUSHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1612 SHEEPSHEAD BAY RD, BROOKLYN, NY 11235-3803
(718) 934-1123
(718) 934-2366
Mailing address
1612 SHEEPSHEAD BAY RD, BROOKLYN, NY 11235-3803
(917) 803-7654
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
VUT006443
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02218697
—
NY
Enumeration date
05/18/2006
Last updated
10/29/2024
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