Provider Demographics
NPI:1629468368
Name:ILOWIT, EMILY
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:ILOWIT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1667 ELIZABETH ST
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12303-3805
Mailing Address - Country:US
Mailing Address - Phone:518-356-5377
Mailing Address - Fax:
Practice Address - Street 1:1667 ELIZABETH ST
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12303-3805
Practice Address - Country:US
Practice Address - Phone:518-356-5377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-03
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY338896363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04059601Medicaid
NY150428000000OtherFIDELIS
NYJ400344427Medicare PIN
NYJ400200824Medicare PIN