Individual
ILYA KRICHAVETS
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 920-2566
Mailing address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 920-2566
Taxonomy
Speciality
Code
Description
License number
State
1835I0206X
Infectious Diseases Pharmacist
Primary
060476
NY
Other
Enumeration date
12/29/2025
Last updated
02/04/2026
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