MEDICARE: JONATHAN S ILOWITE MD

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	207RP1001X	Pulmonary Disease Physician	158477	NY
2	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	158477	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	:	1356403364
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONATHAN S ILOWITE MD

Provider Business Mailing Address
First Line	:	410 LAKEVILLE RD STE 105
Second Line	:
City	:	NEW HYDE PARK
State	:	NY
Zip	:	11042-1102
Country	:	US
Telephone Number	:	516-465-5400
Fax Number	:	516-465-5392

Provider Business Practice Location Address
First Line	:	410 LAKEVILLE RD STE 105
Second Line	:
City	:	NEW HYDE PARK
State	:	NY
Zip	:	11042-1102
Country	:	US
Telephone Number	:	516-465-5400
Fax Number	:	164-655-3925

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

Provider Enumeration Date	:	12/15/2006
Last Update Date	:	04/12/2021

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Directions to “ JONATHAN S ILOWITE MD” Practice Location

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