IRINA ILYASOV (NPI# 1881920502) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881920502 |
| Entity Type | Individual |
| Full Name | IRINA ILYASOV |
| Credential | RPA-C |
| Practice Address |
8686 Bay Pkwy Ste M4 Brooklyn NY 11214-5103 |
| Mailing Address |
62 Keune Ct Staten Island NY 10304-1431 |
| Practice Telephone | 7182657700 |
| Practice Fax Number | 7182657701 |
| Mailing Telephone | 7182657700 |
| Mailing Fax Number | 7182657701 |
| Enumeration Date | 2009-10-30 |
| Last Update Date | 2009-10-30 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
013442 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
8686 BAY PKWY STE M4 |
| City | BROOKLYN |
| State | NY |
| Zip Code | 11214-5103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093721367 | 21st Century Radiology and Imaging, PC | Radiology | 8686 Bay Pkwy, Suite M3, Brooklyn, NY 11214-5119 | 2006-07-31 |
| 1073947156 | Greater Ny Neurology PC | Psychiatry & Neurology | 8686 Bay Pkwy, Suite 1m-2m, Brooklyn, NY 11214-5602 | 2013-08-26 |
| 1568790053 | Bogdan Pain Management Services P.C. | Clinic/Center | 8686 Bay Pkwy, Suite M4, Brooklyn, NY 11214-5103 | 2009-11-23 |
| 1477645158 | Bozena Basewicz-sokol | Physical Medicine & Rehabilitation | 8686 Bay Pkwy, Ste M4, Brooklyn, NY 11214-5119 | 2006-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336763440 | Safe Reach Pt P.C. | Physical Therapist | 331 Bay 14th Street, Fl.#1, Brooklyn, NY 11214 | 2020-06-04 |
| 1891325353 | Mahmoud Ali | Physical Therapist | 96 28th Avenue 3rd Floor, Brooklyn, NY 11214 | 2020-01-23 |
| 1407370489 | Georgette Neglia | Counselor | 195 Bay 19th Street, Brooklyn, NY 11214 | 2017-08-01 |
| 1063936151 | Ummat Pharmacy Inc | Pharmacy | 8719 18th Avenue, Brooklyn, NY 11214 | 2017-07-31 |
| 1518489293 | S&j Pegasus Inc | PACE Provider Organization | 8754 Bay 16th Street, Cellular Floor, Brooklyn, NY 11214 | 2017-07-13 |
| 1063934909 | Edita Greben | Speech-Language Pathologist | 8823 23rd Avenue, 3rd Floor, Brooklyn, NY 11214 | 2017-07-12 |
| 1649791104 | Rachel Sandler | Religious Nonmedical Nursing Personnel | 79- 20th Avenue, Brooklyn, NY 11214 | 2017-07-05 |
| 1003343849 | Catholic Charities Brooklyn and Queens | Case Management | 190 Bay Street, Brooklyn, NY 11214 | 2017-05-11 |
| 1447785316 | Four Season Medical Pllc | Internal Medicine | 2044 86th Street, Brooklyn, NY 11214 | 2017-04-27 |
| 1134669716 | Uhealthy Pharmacy Inc. | Pharmacy | 2263 86th Street, Brooklyn, NY 11214 | 2017-03-02 |
| Find all providers in zip 11214 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710517305 | Angenis Lin | Physician Assistant | 1526 83rd St, Brooklyn, NY 11228-3130 | 2020-01-22 |
| 1740848985 | Mallory Des Champs | Physician Assistant | 7901 4th Ave Ste A20, Brooklyn, NY 11209-3957 | 2019-06-03 |
| 1588140230 | Sharon Cheptum Griesinger | Physician Assistant | 276 Hawthorne St Apt 1, Brooklyn, NY 11225-5908 | 2018-07-16 |
| 1336651629 | Francine Panely | Physician Assistant | 460 Neptune Ave Apt 18r, Brooklyn, NY 11224-4325 | 2017-10-26 |
| 1265951479 | Leah Mcmullen | Physician Assistant | 803 Nostrand Ave Apt 1l, Brooklyn, NY 11225-1539 | 2017-09-19 |
| 1033655378 | Zacharia El-samin | Physician Assistant | 21 Pine Tree Ter, Brooklyn, CT 06234-3324 | 2017-01-10 |
| 1982156816 | Chad Smartt | Physician Assistant | 988 E 39th St, Brooklyn, NY 11210-3508 | 2016-10-26 |
| 1154870913 | Christina Masaitis | Physician Assistant | 2171 E 18th St, Apt 1c, Brooklyn, NY 11229-4468 | 2016-09-22 |
| 1447615737 | Eliezer Gurkov | Physician Assistant | 888 Montgomery St, Apt F12, Brooklyn, NY 11213-5888 | 2015-12-31 |
| 1588039846 | Inna Kremen | Physician Assistant | 2829 Ocean Pkwy Ste 3, Brooklyn, NY 11235-7859 | 2015-12-11 |
| Find all providers in BROOKLYN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.