| Igor Ilyabayev D.d.s., P.c. | |
|
139 N Central Ave Ste 3 Valley Stream NY 11580-3859 | |
| (516) 887-0020 | |
| Not Available |
| Full Name | Igor Ilyabayev D.d.s., P.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 139 N Central Ave Ste 3, Valley Stream, New York |
| Authorized Official Name and Position | Igor Ilyabayev (DENTIST) |
| Authorized Official Contact | 5168870020 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Igor Ilyabayev D.d.s., P.c. 139 N Central Ave Ste 3 Valley Stream NY 11580-3859 Ph: (516) 887-0020 | Igor Ilyabayev D.d.s., P.c. 139 N Central Ave Ste 3 Valley Stream NY 11580-3859 Ph: (516) 887-0020 |
| NPI Number | 1093045361 |
|---|---|
| Provider Enumeration Date | 01/07/2010 |
| Last Update Date | 01/05/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093045361 | NPI | - | NPPES |
| 03168361 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 052814 (New York) | Primary |
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