Provider Demographics
NPI:1023354081
Name:SHTARKMAN, ILONA (DPM)
Entity type:Individual
Prefix:DR
First Name:ILONA
Middle Name:
Last Name:SHTARKMAN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:ILONA
Other - Middle Name:
Other - Last Name:OCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:20 E 46TH ST RM 200
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-9287
Mailing Address - Country:US
Mailing Address - Phone:212-871-0800
Mailing Address - Fax:
Practice Address - Street 1:20 E 46TH ST RM 200
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-9287
Practice Address - Country:US
Practice Address - Phone:212-871-0800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-19
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN006619213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery