MEDICARE: DR. JOHN LAYLIEV M.D.

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	208600000X	Surgery Physician	259107	NY
2	2082S0105X	Surgery of the Hand (Plastic Surgery) Physician	259107-01	NY

General Provider Information

NPI Number	:	1891950093
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN LAYLIEV M.D.

Provider Business Mailing Address
First Line	:	110 E MAIN ST STE 6
Second Line	:
City	:	HUNTINGTON
State	:	NY
Zip	:	11743-2845
Country	:	US
Telephone Number	:	631-424-3600
Fax Number	:

Provider Business Practice Location Address
First Line	:	110 E MAIN ST STE 6
Second Line	:
City	:	HUNTINGTON
State	:	NY
Zip	:	11743-2845
Country	:	US
Telephone Number	:	631-424-3600
Fax Number	:

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

Provider Enumeration Date	:	07/28/2008
Last Update Date	:	04/24/2026

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