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General NPI Number Information
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NPI Number | 1356134241
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Entity Type | Organization
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Legal Business Name | KAMILLA ISMAILOFF, MD, PC
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Dates
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Enumeration Date | 05/23/2025
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Last Update Date | 02/13/2026
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Provider Practice Location Address
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Address Line | 11014 LIBERTY AVE FL 1
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City | SOUTH RICHMOND HILL
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State | NY
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Zip | 11419-1706
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Country | US
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Telephone | 347-414-2345
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Fax |
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Provider Business Mailing Address
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Address Line | 6910 108TH ST APT 9E
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City | FOREST HILLS
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State | NY
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Zip | 11375-3814
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Country | US
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Telephone | 347-414-2345
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Fax | 631-938-0648
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Authorized Official
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Title or Position | OWNER
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Name | KAMILLA ISMAILOFF
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Credential | MD
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Telephone | 347-414-2345
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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