| Ilyaev Medicine PLLC | |
|
1659 Ralph Ave Brooklyn NY 11236-3317 | |
| (718) 255-9955 | |
| Not Available |
| Full Name | Ilyaev Medicine PLLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 1659 Ralph Ave, Brooklyn, New York |
| Authorized Official Name and Position | Stella Ilyaev (OWNER) |
| Authorized Official Contact | 7182559955 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ilyaev Medicine PLLC 1659 Ralph Ave Brooklyn NY 11236-3317 Ph: (718) 255-9955 | Ilyaev Medicine PLLC 1659 Ralph Ave Brooklyn NY 11236-3317 Ph: (718) 255-9955 |
| NPI Number | 1922853464 |
|---|---|
| Provider Enumeration Date | 04/18/2024 |
| Last Update Date | 04/18/2024 |
| Certification Date | 04/18/2024 |
| Medicare PECOS PAC ID | 7416490297 |
|---|---|
| Medicare Enrollment ID | O20240621000368 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922853464 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Stella Ilyaev |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912907742 PECOS PAC ID: 4981613387 Enrollment ID: I20060412000662 |
| Provider Name | Marat Chaikhoutdinov |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063590891 PECOS PAC ID: 1557301942 Enrollment ID: I20070227000260 |
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