Individual
MARY CLARISSE L KILAYKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
161 CAREY RD, QUEENSBURY, NY 12804-7821
(518) 824-8610
(518) 824-2390
Mailing address
9 CAREY RD, QUEENSBURY, NY 12804-7880
(518) 761-0300
(518) 824-2388
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
003790
NY
207RI0200X
Infectious Disease Physician
Primary
003790
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03375853
—
NY
Enumeration date
01/08/2009
Last updated
02/07/2017
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