MEDICARE: DR. INNA PILDYSH DO

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	207R00000X	Internal Medicine Physician	223047	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316914021
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. INNA PILDYSH DO

Provider Business Mailing Address
First Line	:	2345 65TH STREET
Second Line	:	COMPASSIONATE MEDICINE P.C.
City	:	BROOKLYN
State	:	NY
Zip	:	11204
Country	:	US
Telephone Number	:	718-645-4800
Fax Number	:	718-645-4949

Provider Business Practice Location Address
First Line	:	2345 65TH STREET
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11204
Country	:	US
Telephone Number	:	718-645-4800
Fax Number	:	718-645-4949

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

Provider Enumeration Date	:	03/01/2006
Last Update Date	:	07/19/2010

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