DR. STANISLAV V ILYUSHA O.D. NPI 1750334264

NPI Information

NPI: 1750334264
Provider Name: DR. STANISLAV V ILYUSHA, O.D.
Classification: Optometrist - 152WC0802X
Entity Type: Individual

Specialization: Corneal and Contact Management

Organization: BAY RIDGE VISION CENTER LLC

PECOS Registration: Yes

Address:
1501 GRAVESEND NECK RD
BROOKLYN, NY
ZIP 11229
Phone: (718) 787-4111
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DR. Stanislav V Ilyusha, O.D. is a corneal and contact management optometrist in Brooklyn, NY with 23 years of experience. The provider is the professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea's ability to sustain successful contact lens wear, and treatment of any external eye or corneal condition which can affect contact lens wear. DR. Stanislav V Ilyusha, O.D. NPI is 1750334264. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: PENNSYLVANIA COLLEGE OF OPTOMETRY
Graduation Year:2001

The provider's business location address is:

1501 GRAVESEND NECK RD
BROOKLYN, NY
ZIP 11229-434
Phone: (718) 787-4111

The NPI 1750334264 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 5/18/2006 and was last updated on 7/1/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	152WC0802X	Optometrist	Corneal and Contact Management	VUT006443	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	U89143	MEDICARE UPIN	NEW YORK
2	C191E2	MEDICARE PIN	NEW YORK
3	02218697	MEDICAID	NEW YORK
4	5175500001	MEDICARE NSC

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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