Search › New York › 122300000X
Illya Tarasenko, DMD
NPI 1720238090 · on the registry since 2008 · sole proprietor
Practice
- Address
- 139 Kane St
#4
Brooklyn, NY 11231 - Phone
- (267) 304-4701
Registry record
- Primary taxonomy
- 122300000X
122300000X
- Also registered as
- 122300000X
- Licence states on file
- NY, PA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2008-09-23
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