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Ilha Kostyuchenko
NPI 1528306560 · on the registry since 2013
Practice
- Address
- 3440 78th St
Apt 2c
Jackson Heights, NY 11372 - Phone
- (646) 732-9613
Registry record
- Primary taxonomy
- 163W00000X
163W00000X
- Licence states on file
- NY
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2013-01-25
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New York