Provider Demographics
NPI:1457399008
Name:STOLYAR, EMMA BORIS (DO)
Entity type:Individual
Prefix:DR
First Name:EMMA
Middle Name:BORIS
Last Name:STOLYAR
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:8405 BAY PKWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-3359
Mailing Address - Country:US
Mailing Address - Phone:718-232-1120
Mailing Address - Fax:718-232-1136
Practice Address - Street 1:8405 BAY PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-3359
Practice Address - Country:US
Practice Address - Phone:718-232-1120
Practice Address - Fax:718-232-1136
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY213445207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01984427Medicaid
NY11V831Medicare PIN
NYH01631Medicare UPIN