Provider Demographics
NPI:1558546614
Name:ILSON, JOYCE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOYCE
Middle Name:
Last Name:ILSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:137 DEVOE ST
Mailing Address - Street 2:2L
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-3720
Mailing Address - Country:US
Mailing Address - Phone:718-218-9390
Mailing Address - Fax:212-305-3389
Practice Address - Street 1:137 DEVOE ST
Practice Address - Street 2:2L
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-3720
Practice Address - Country:US
Practice Address - Phone:718-218-9390
Practice Address - Fax:212-305-3389
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-08
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1331242084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB18627Medicare UPIN