MEDICARE: ILYA KUDRIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1033041488
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ILYA KUDRIN

Provider Business Mailing Address
First Line	:	484 W 43RD ST APT 11D
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10036-6337
Country	:	US
Telephone Number	:	917-213-8167
Fax Number	:

Provider Business Practice Location Address
First Line	:	484 W 43RD ST APT 11D
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10036-6337
Country	:	US
Telephone Number	:	917-213-8167
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

Similar Medicare Providers

1275528622 — MS. LOIS ANN CIPRIANO MS LCSW
Practice Location Address:

146 W 80TH ST , #4F
NEW YORK, NY
10024-6337

Practice Phone: 212-877-3792
Practice Fax:

1497160923 — DR. DANIEL GIORDANO DPT, CSCS
Practice Location Address:

295 MADISON AVE RM 1826
NEW YORK, NY
10017-6337

Practice Phone: 646-201-1469
Practice Fax:

1144756404 — DR. KATHARINE HARPER DPT
Practice Location Address:

295 MADISON AVE RM 1826
NEW YORK, NY
10017-6337

Practice Phone: 646-596-7427
Practice Fax: 646-358-3443

1831602945 — CAMERON JAMES YUEN PT, DPT, CSCS
Practice Location Address:

295 MADISON AVE RM 1826
NEW YORK, NY
10017-6337

Practice Phone: 646-596-7427
Practice Fax:

1881175123 — GIORNANDA RODRIGUEZ
Practice Location Address:

442 W 160TH ST APT 6C
NEW YORK, NY
10032-6337

Practice Phone: 917-564-7156
Practice Fax:

1700273687 — RESOURCES FOR HUMAN DEVELOPMENT
Practice Location Address:

2626 UPPERLINE ST
NEW ORLEANS, LA
70115-6337

Practice Phone: 610-209-0144
Practice Fax:

Directions to “ ILYA KUDRIN ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.