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Individual

ILYA LESKOV

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D., PH.D.

Contact information

Practice address
243 CHARLES ST, BOSTON, MA 02114-3002
(617) 523-7900
Mailing address
450 CLARKSON AVE, BROOKLYN, NY 11203-2012

Taxonomy

Speciality
Code
Description
License number
State
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
295576
NY
390200000X
Student in an Organized Health Care Education/Training Program
252660
MA

Other

Enumeration date
07/16/2012
Last updated
03/22/2022
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