Provider Demographics
NPI:1376361584
Name:ZILBERBORD, ILYA
Entity type:Individual
Prefix:
First Name:ILYA
Middle Name:
Last Name:ZILBERBORD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2110 AVENUE X
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-2911
Mailing Address - Country:US
Mailing Address - Phone:347-332-9340
Mailing Address - Fax:
Practice Address - Street 1:2110 AVENUE X
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-2911
Practice Address - Country:US
Practice Address - Phone:347-332-9340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-27
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)