ATLANTIC ENDOCRINOLOGY AND DIABETES PC; NPI #1407059199

Contact Information

ATLANTIC ENDOCRINOLOGY AND DIABETES PC

9725 63RD DR
REGO PARK, NY 11374-2229

Phone: 718-275-2900
Fax: 718-275-2944
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Endocrinology, Diabetes & Metabolism	207RE0101X	11	Physician/Internal Medicine
Allergy & Immunology	207K00000X	03	Physician/Allergy/ Immunology
Family Medicine	207Q00000X	08	Physician/Family Practice
Nephrology	207RN0300X	11	Physician/Internal Medicine
Neurology	2084N0400X	13	Physician/Neurology
Physical Therapist	225100000X	65	Physical Therapist in Private Practice
Podiatrist	213E00000X	48	Podiatry
Thoracic Surgery (Cardiothoracic Vascular Surgery)	208G00000X	02	Physician/General Surgery

Indicates primary specialty

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NPI Profile & details for ATLANTIC ENDOCRINOLOGY AND DIABETES PC

NPI Number 1407059199

LBN Legal business name ATLANTIC ENDOCRINOLOGY AND DIABETES PC

Authorized official STELLA ILYAYEVA - (MD)

Entity Organization

Organization subpart ¹ No

Enumeration date 06/08/2007

Last updated 02/18/2026 - About 4 months ago

Identifiers

NY	Medicaid	02148396
NY	Medicaid	03436793

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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ATLANTIC ENDOCRINOLOGY AND DIABETES PC

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NPI Profile & details for ATLANTIC ENDOCRINOLOGY AND DIABETES PC

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