Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0102X | Surgical Critical Care | 281259 | NY |
NPI | 1184068421 |
---|---|
Provider Name | Dr. Ilya Shnaydman |
First Address | Hawthorne, NY 10532-2140 |
Second Address | Valhalla, NY 10595-1530 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2013 |
Last Update Date | 30/11/2021 |