| Mark Ilyagu Medical Pc | |
|
221 Sea Breeze Ave Apt Ph2b Brooklyn NY 11224-3454 | |
| (718) 790-8718 | |
| Not Available |
| Full Name | Mark Ilyagu Medical Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 221 Sea Breeze Ave Apt Ph2b, Brooklyn, New York |
| Authorized Official Name and Position | Mark Ilyagu (MD) |
| Authorized Official Contact | 7177167107 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark Ilyagu Medical Pc 221 Sea Breeze Ave Apt Ph2b Brooklyn NY 11224-3454 Ph: (718) 790-8718 | Mark Ilyagu Medical Pc 221 Sea Breeze Ave Apt Ph2b Brooklyn NY 11224-3454 Ph: (718) 790-8718 |
| NPI Number | 1619699915 |
|---|---|
| Provider Enumeration Date | 09/13/2022 |
| Last Update Date | 12/20/2023 |
| Medicare PECOS PAC ID | 6800272477 |
|---|---|
| Medicare Enrollment ID | O20221005000992 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619699915 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Hong Mak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437568383 PECOS PAC ID: 9931497062 Enrollment ID: I20161005001863 |
| Provider Name | Mark Ilyagu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073994711 PECOS PAC ID: 8820340151 Enrollment ID: I20181015000980 |
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